Efficacy of targeted supradose cisplatin and concomitant radiation therapy for advanced head and neck cancer: The Memphis experience

Robbins, K. Thomas; Kumar, Parvesh; Regine, William F.; Wong, Frank S. H.; Weir, Alva B.; Flick, Pamela; Kun, Larry E.; Palmer, Robert L.; Murry, Thomas; Fontanesi, James; Ferguson, R.; Thomas, Randal; Hartsell, William F.; Paig, Camilo; Salazar, George; Norfleet, Linda; Hanchett, Catherine; Harrington, Vanessa; Niell, Harvey B.

doi:10.1016/s0360-3016(97)00092-8

Cited by 150 publications

(95 citation statements)

References 29 publications

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“…However, in established cases of oral carcinomas or other head and neck cancers, chemotherapy has been demonstrated to play a significant role in their management [43,115,128,148]. taxanes are also regarded as radiation sensitizers [125]. Recent interest has been shown in intra-arterial delivery of chemotherapy, which increases the drug dose to the tumor and decreases systemic toxicity [125].…”

Section: Discussionmentioning

confidence: 99%

“…taxanes are also regarded as radiation sensitizers [125]. Recent interest has been shown in intra-arterial delivery of chemotherapy, which increases the drug dose to the tumor and decreases systemic toxicity [125]. Neoadjuvant chemotherapy has not been shown to improve survival rates [57,63] and few data exist on adjuvant chemotherapy after radiation therapy.…”

Section: Discussionmentioning

confidence: 99%

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A meta-analysis of the randomized controlled trials on elective neck dissection versus therapeutic neck dissection in oral cavity cancers with clinically node-negative neck

et al. 2011

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

A meta-analysis of the randomized controlled trials on elective neck dissection versus therapeutic neck dissection in oral cavity cancers with clinically node-negative neck

et al. 2011

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“…Details on this treatment modality were published previously. 8,13,14 Briefly, treatment consisted of 4 consecutive weekly, selective, intraarterial infusions of cisplatin (150 mg/m 2 ) followed by intravenous sodium thiosulfate rescue combined with simultaneous radiotherapy according to the RADPLAT protocol 15 (2 gray [Gy] per day, 5 times per week for 7 weeks to a total dose of 70 Gy). Before the start of treatment, all patients signed an informed consent form that was approved by our Institutional Protocol Review Committee.…”

Section: Methodsmentioning

confidence: 99%

Response measurement after intraarterial chemoradiation in advanced head and neck carcinoma

Broek

Rasch

Pameijer

et al. 2006

Cancer

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BACKGROUNDThe objectives of this prospective trial were to evaluate the diagnostic accuracy and predictive value of magnetic resonance imaging (MRI) and to use MRI evaluation under general anesthesia (EGA) 6 to 8 weeks after chemoradiation to determine local control.METHODSEighty‐two consecutive patients with advanced‐stage squamous cell carcinoma of the oral cavity, oropharynx, hypopharynx, or supraglottic larynx were treated with selective targeted chemoradiation. All patients who completed treatment and survived had a minimum follow‐up of 3 years. MRI and EGA were performed from 6 to 8 weeks after treatment. Posttreatment MRI findings were compared with pretreatment MRI findings and were graded for risk of local recurrence/residual disease on a 4‐point scale. The diagnosis of treatment failure was based on tissue biopsies, which were obtained during EGA or later during follow‐up. The predictive value of MRI was analyzed by using a Cox proportional hazards model.RESULTSOnly 1 patient with MRI Grade 0 or 1 findings (discrete mass < 10 mm; n = 62 patients) had residual disease 6 to 8 weeks after treatment that was detected during EGA. In 5 patients with MRI findings of Grade 2a and 2b (mass > 10 mm; n = 20 patients), residual disease was detected. After 2 years, 23 patients had a local failure (28%). Twelve local failures were found among 62 patients who had MRI findings of Grade 0 and 1. Posttreatment MRI emerged as an independent predictive factor (hazard ratio, 3.0; P = .014) for local control.CONCLUSIONSPosttreatment MRI studies provided predictive information on local control in addition to pretreatment predictors. In patients with focal masses < 10 mm, the combination of response evaluation under general anesthesia and posttreatment MRI from 6 to 8 weeks after chemoradiation hardly provided more information on the local control than posttreatment MRI alone. Cancer 2006. © 2006 American Cancer Society.

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“…At a median follow-up of 22 months, the projected 3-year overall and disease-free survival rates were 88% and 53%, respectively. Further studies from this group subsequently confirmed these promising response and survival rates, and extended the application of RADPLAT from patients with functionally inoperable disease only to an organ-preserving approach in patients with technically resectable disease [39,40].…”

Section: Study Outcomesmentioning

confidence: 75%

RADPLAT: An Alternative to Surgery?

2006

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Head and neck cancer frequently presents at a late stage, leading to a poor prognosis despite optimal treatment with surgery and/or radiotherapy. Chemotherapy for advanced disease has shown little benefit as a single-modality treatment, and the use of concurrent chemoradiation is limited by problems with severe toxicity at higher doses. RADPLAT is the acronym used to describe a new technique, combining intra-arterial delivery of cisplatin with systemic neutralization by i.v. sodium thiosulphate, and concurrent radiotherapy. This allows very high cisplatin dose intensities to be used while potentially minimizing adverse systemic effects. Initial results suggest that excellent locoregional control rates are achievable in patients with unresectable disease, with a favorable side-effect profile when compared with conventional chemoradiation protocols. In addition, RADPLAT may potentially be of benefit in selected patients with resectable disease, allowing for preservation of organ function and quality of life without compromising locoregional control or survival. While current phase II data are encouraging, phase III randomized controlled trials are required in order to directly compare RADPLAT with i.v. chemoradiation therapy, the current standard of care. This article reviews the evolution of the RADPLAT concept, from initial clinical trials to its current application in the treatment of patients with advanced head and neck cancer.

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Efficacy of targeted supradose cisplatin and concomitant radiation therapy for advanced head and neck cancer: The Memphis experience

Cited by 150 publications

References 29 publications

A meta-analysis of the randomized controlled trials on elective neck dissection versus therapeutic neck dissection in oral cavity cancers with clinically node-negative neck

A meta-analysis of the randomized controlled trials on elective neck dissection versus therapeutic neck dissection in oral cavity cancers with clinically node-negative neck

Response measurement after intraarterial chemoradiation in advanced head and neck carcinoma

RADPLAT: An Alternative to Surgery?

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