Sequential chemo-radiotherapy in locally advanced squamous cell carcinoma of the head and neck

Wendt, Thomas; Chucholowski, Michael; Hartenstein, R.; Rohloff, R.; Willich, Normann

doi:10.1016/0360-3016(86)90357-3

Cited by 14 publications

(3 citation statements)

References 8 publications

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“…Comparing the results of our trial to those obtained by other institutions with conventional simultaneous 5-fluorouracil/cis-platinum containing chemoradiotherapy without folinic acid [9,10], there appears to be an advantage in tumor response in favor of our treatment pro gram, considering the particularly higher tumor stages in our study. It also seems to provide superior survival and local control rates as compared to historical controls treated con ventionally with radiotherapy alone or with sequential chcmoradiotherapy [5,11].…”

Section: Discussionmentioning

confidence: 99%

Simultaneous Chemo-Radiotherapy with 5-FU/Folinic Acid/cis-Platinum and Accelerated Split-Course Radiation in Advanced Head and Neck Cancer

Hartenstein

Wendt²,

Kastenbauer³

et al. 1989

Oncol Res Treat

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In a clinical phase-II trial, 62 previously untreated patients suffering from unresectable stage III (4 patients) and IV (56 patients) squamous cell carcinoma of the head and neck were treated with a simultaneous chemoradiotherapy consisting of a 5-fluorouracil/folinic acid/cis-platinum combination and of an accelerated split-course radiotherapy. As results, 3 patients died from tumor arrosion bleeding during the treatment. The median follow-up time of the surviving patients is 27 + months (range 18–44 months). Forty-eight out of 62 patients (77%) achieved complete remission, and 11/62 patients (18%) partial remission. Presently, 32 patients (52%) are without evidence of disease. The actuarial 3-year overall survival rate (Kaplan-Meier method) out of 62 patients is 53%. The actuarial disease-free survival and local tumor control rates at 3 years are 58% and 72%. Toxicity on oral mucosa was severe but tolerable, bone marrow depression was marked but not life-threatening. In conclusion, this combined simultaneous modality approach is highly effective in locally advanced head and neck cancer. It appears to provide superior survival and local control rates as compared to conventional radiotherapy or sequential chemoradiotherapy.

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Section: Discussionmentioning

confidence: 99%

Simultaneous Chemo-Radiotherapy with 5-FU/Folinic Acid/cis-Platinum and Accelerated Split-Course Radiation in Advanced Head and Neck Cancer

Hartenstein

Wendt²,

Kastenbauer³

et al. 1989

Oncol Res Treat

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“…The rationale for combining radio-and chemotherapy is that, as the toxicity of these modalities does not entirely overlap, an enhanced tumouricidal effect may be obtained (Wendt et al, 1985).…”

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confidence: 99%

Anaplastic thyroid carcinoma: three protocols combining doxorubicin, hyperfractionated radiotherapy and surgery

et al. 2002

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Patients with anaplastic thyroid carcinoma can rarely be cured, but every effort should be made to prevent death due to suffocation. Between 1984 and 1999, 55 consecutive patients with anaplastic thyroid carcinoma were prospectively treated according to a combined regimen consisting of hyperfractionated radiotherapy, doxorubicin, and when feasible surgery. Radiotherapy was carried out for 5 days a week. The daily fraction until 1988 was 1.0 Gy×2 (A) and 1989–92 1.3 Gy×2 (B) . Thereafter 1.6 Gy×2 (C) was administered. Radiotherapy was administered to a total target dose of 46 Gy; of which 30 Gy was administered preoperatively in the first two protocols (A and B), while the whole dose was given preoperatively in the third protocol (C). The therapy was otherwise identical. Twenty mg doxorubicin was administered intravenously weekly. Surgery was possible in 40 patients. No patient failed to complete the protocol due to toxicity. In only 13 cases (24%) was death attributed to local failure. Five patients (9%) ‘had a survival’ exceeding 2 years. No signs of local recurrence were seen in 33 patients (60%); 5 out of 16 patients in Protocol A, 11 out of 17 patients in Protocol B, 17 out of 22 patients in Protocol C ( P =0.017). In the 40 patients undergoing additional surgery, no signs of local recurrence were seen in 5 out of 9 patients, 11 out of 14 patients and 17 out of 17 patients, respectively ( P =0.005). British Journal of Cancer (2002) 86 , 1848–1853. doi: 10.1038/sj.bjc.6600361 www.bjcancer.com © 2002 Cancer Research UK

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“…Surgery, radiation therapy, or chemotherapy used alone is seldom adequate to control the disease (1, 23), though a combination of these modalities might at least improve local control (23,24). The rationale for combining radio-and chemotherapy is that, as the toxicity of these modalities is not entirely overlapping, an enhanced tumoricidal effect might be obtained (25).…”

Section: Local Tumour Controlmentioning

confidence: 99%

Anaplastic Giant Cell Thyroid Carcinoma

2004

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Anaplastic (giant cell) thyroid carcinoma (ATC), is one of the most aggressive malignancies in humans with a median survival time after diagnosis of 3-6 months. Death from ATC was earlier seen because of local growth and suffocation. ATC is uncommon, accounting for less than 5 % of all thyroid carcinomas. The diagnosis can be established by means of multiple fine needle aspiration biopsies, which are neither harmful nor troublesome for the patient. The cytological diagnosis of this high-grade malignant tumour is usually not difficult for a well trained cytologist. The intention to treat patients with ATC is cure, although only few of them survive. The majority of the patients are older than 60 years and treatment must be influenced by their high age. We have by using a combined modality regimen succeeded in achieving local control in most patients. Every effort should be made to control the primary tumour and thereby improve the quality of remaining life and it is important for patients, relatives and the personnel to know that cure is not impossible. Different treatment combinations have been used since 30 years including radiotherapy, cytostatic drugs and surgery, when feasible. In our latest combined regimen, 22 patients were treated with hyper fractionated radiotherapy 1.6Gy x 2 to a total target dose of 46 Gy given preoperatively, 20 mg doxorubicin was administered intravenously once weekly and surgery was carried out 2-3 weeks after the radiotherapy. 17 of these 22 patients were operated upon and none of these 17 patients got a local recurrence. In the future we are awaiting the development of new therapeutic approaches to this aggressive type of carcinoma. Inhibitors of angiogenesis might be useful. Combretastatin has displayed cytotoxicity against ATC cell lines and has had a positive effect on ATC in a patient. Sodium iodide symporter (NIS) genetherapy is also being currently considered for dedifferentiated thyroid carcinomas with the ultimate aim of making radio-iodine therapy possible.

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Sequential chemo-radiotherapy in locally advanced squamous cell carcinoma of the head and neck

Cited by 14 publications

References 8 publications

Simultaneous Chemo-Radiotherapy with 5-FU/Folinic Acid/cis-Platinum and Accelerated Split-Course Radiation in Advanced Head and Neck Cancer

Simultaneous Chemo-Radiotherapy with 5-FU/Folinic Acid/cis-Platinum and Accelerated Split-Course Radiation in Advanced Head and Neck Cancer

Anaplastic thyroid carcinoma: three protocols combining doxorubicin, hyperfractionated radiotherapy and surgery

Anaplastic Giant Cell Thyroid Carcinoma

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