Prospektive Phase-II-Studie zur neoadjuvanten Radiochemotherapie fortgeschrittener, operabler Mundhöhlenkarzinome

Eckardt, A.; Rades, Dirk; Rudat, Volker; Hofele, Christof; Dammer, R.; Dietl, B.; Wildfang, I.; Karstens, Johann H.

doi:10.1007/s10006-002-0370-y

Cited by 21 publications

(6 citation statements)

References 12 publications

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“…Other outcome surveys of a similar therapeutic concept (preoperative RCT and radical surgery) reported about smaller cohorts and shorter periods of surveillance. Survival and control probability were found in a similar range with 2-year overall survival probabilities ranging from 63 to 86% and 2-year local control probabilities ranging from 68 to 84% 6,7,15,20 . Comparison with outcome data reported after postoperative adjuvant RCT is difficult.…”

Section: Discussionmentioning

confidence: 52%

“…It was shown that RT is likely to be more effective in otherwise unaffected and well oxygenated tissue 3,9,21 . The concept of administering RCT before surgery has been reported in studies by DOBROWSKY et al 6 , MOHR et al 20 , KIRITA et al 15 , and ECKARDT et al 7 . These authors report 2-year overall survival probabilities ranging from 63 to 86% and 2-year local control probabilities ranging from 68 to 84%.…”

mentioning

confidence: 94%

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Preoperative radiochemotherapy and radical resection for stages II–IV oral and oropharyngeal cancer: outcome of 222 patients

Klug

Wutzl

Kermer

et al. 2005

International Journal of Oral and Maxillofacial Surgery

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Section: Discussionmentioning

confidence: 52%

mentioning

confidence: 94%

Preoperative radiochemotherapy and radical resection for stages II–IV oral and oropharyngeal cancer: outcome of 222 patients

Klug

Wutzl

Kermer

et al. 2005

International Journal of Oral and Maxillofacial Surgery

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“…Of 20 patients included in this study (March 2004 - October 2006), 10 patients where treated without previous radiotherapy (group 1), five patients received conventional radiotherapy (59.4 - 72 Gy) (group 2) at least 22 months before surgery and another five patients received neoadjuvant chemoradiation 6 weeks before surgery (group 3, Table 1). The neoadjuvant chemoradiation protocol included cisplatin 12.5 mg/m 2 plus 40 Gy radiation or paclitaxel 40 mg/m 2 /carboplatin AUC 1.5 plus 40 Gy radiation [1,2]. During surgical procedure, 5-10 mm long vessel specimens where obtained by the surgeon.…”

Section: Methodsmentioning

confidence: 99%

“…The therapy of patients suffering from oral cancer could be recently improved by utilization of multimodal interdisciplinary regimes using a combination of surgery, chemo- and radiotherapy [1,2]. Extensive tissue defects following ablative tumor therapy do require adequate and functional reconstruction regardless of whether the patient received preoperative irradiation or not.…”

Section: Introductionmentioning

confidence: 99%

Effect of neoadjuvant chemoradiation and postoperative radiotherapy on expression of heat shock protein 70 (HSP70) in head and neck vessels

et al. 2011

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BackgroundPreoperative radiotherapy and chemotherapy in patients with head and neck cancer result in changes to the vessels that are used to construct microsurgical anastomoses. The aim of the study was to investigate quantitative changes and HSP70 expression of irradiated neck recipient vessels and transplant vessels used for microsurgical anastomoses.MethodsOf 20 patients included in this study five patients received neoadjuvant chemoradiation, another five received conventional radiotherapy and 10 patients where treated without previous radiotherapy. During surgical procedure, vessel specimens where obtained by the surgeon. Immunhistochemical staining of HSP70 was performed and quantitative measurement and evaluation of HSP70 was carried out.ResultsConventional radiation and neoadjuvant chemoradiation revealed in a thickening of the intima layer of recipient vessels. A increased expression of HSP70 could be detected in the media layer of the recipient veins as well as in the transplant veins of patients treated with neoadjuvant chemoradiation. Radiation and chemoradiation decreased the HSP70 expression of the intima layer in recipient arteries. Conventional radiation led to a decrease of HSP70 expression in the media layer of recipient arteries.ConclusionOur results showed that anticancer drugs can lead to a thickening of the intima layer of transplant and recipient veins and also increase the HSP70 expression in the media layer of the recipient vessels. In contrast, conventional radiation decreased the HSP70 expression in the intima layer of arteries and the media layer of recipient arteries and veins. Comparing these results with wall thickness, it was concluded, that high levels of HSP70 may prevent the intima layer of arteries and the media layer of vein from thickening.

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“…A potential outcome advantage for chemoradiotherapy in head and neck cancer has been further examined in several meta-analyses between 1990 and 2001 [3,18,19,20]. Its effectiveness concerning locoregional tumor control and recurrence-free survival was shown [6] previously, as well as a good activity of the combination with paclitaxel/carboplatin [11,21,22,23,24]. This high effectiveness was confirmed by the initially published 1- and 3-year results of the presented study where the overall survival rate after 3 years was 84% [25].…”

Section: Discussionmentioning

confidence: 99%

Preoperative Paclitaxel/Carboplatin Radiochemotherapy for Stage III/IV Resectable Oral and Oropharyngeal Cancer: Seven-Year Follow-Up of a Phase II Trial

Eckardt

Sinikovic²,

Hofele³

et al. 2007

Oncology

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Numerous treatment concepts for advanced but resectable oral and oropharyngeal squamous cell carcinoma exist. In this study, we present the 7-year results of a promising treatment with preoperative simultaneous chemoradiation using paclitaxel and carboplatin within a prospective phase II trial comprising 56 patients. After determination of the local tumor extension, chemoradiation was applied for 4 weeks and up to 40 Gy. Following a recovery period of 3–4 weeks, tumor resection was performed within the initially tattooed resection margins, together with a functional modified neck dissection. The median follow-up time was 44.9 ± 19.6 months (range 0.76–87.9). After 7 years, 35 (63.3%) patients were alive and 20 (36.4%) had died. In 2 patients (3.6%), the cause of death was related to treatment. After 7 years, the overall survival rate declined to 63.6%, whereas the local recurrence-free probability was still 84.2%. These results confirm the excellent local control and high survival rates of preoperative radiochemotherapy with the combination of paclitaxel/carboplatin.

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Prospektive Phase-II-Studie zur neoadjuvanten Radiochemotherapie fortgeschrittener, operabler Mundhöhlenkarzinome

Abstract: Our present results demonstrated impressive clinical and pathological response rates of concurrent Taxol/carboplatin and radiotherapy as a preoperative treatment modality in advanced oral and oropharyngeal cancer.

Cited by 21 publications

References 12 publications

Preoperative radiochemotherapy and radical resection for stages II–IV oral and oropharyngeal cancer: outcome of 222 patients

Preoperative radiochemotherapy and radical resection for stages II–IV oral and oropharyngeal cancer: outcome of 222 patients

Effect of neoadjuvant chemoradiation and postoperative radiotherapy on expression of heat shock protein 70 (HSP70) in head and neck vessels

Preoperative Paclitaxel/Carboplatin Radiochemotherapy for Stage III/IV Resectable Oral and Oropharyngeal Cancer: Seven-Year Follow-Up of a Phase II Trial

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