Targeted chemoradiation for advanced head and neck cancer: Analysis of 213 patients

Robbins, K. Thomas; Kumar, Parves; Wong, Frank S. H.; Hartsell, William F.; Flick, Pamela; Palmer, Robert L.; Weir, Alva B.; Neill, H. Barry; Murry, Thomas; Ferguson, R.; Hanchett, Catherine; Vieira, Francisco; Bush, Andrew; Howell, Stephen B.

doi:10.1002/1097-0347(200010)22:7<687::aid-hed8>3.3.co;2-n

Cited by 68 publications

(107 citation statements)

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“…One patient with T4N0 cancer of the tonsillar fossa received RT and four cycles of intra-arterial cisplatin (RADPLAT). 17 A second patient underwent surgery for a T4N0 maxillary sinus lesion and had diffusely positive margins; he received weekly paclitaxel during a course of hyperfractionated postoperative RT.…”

Section: Methodsmentioning

confidence: 99%

Radiotherapy alone or combined with surgery for adenoid cystic carcinoma of the head and neck

et al. 2004

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Background. The purpose of this study was to analyze the results of radiotherapy (RT) alone or combined with surgery for adenoid cystic carcinoma.Methods. Between September 1966 and November 2001, 101 previously untreated patients were treated with curative intent with RT alone or combined with surgery. Follow-up ranged from 0.4 to 30.6 years (median, 6.6 years). All living patients had follow-up for at least 1 year.Results. The 5-and 10-year rates of local control were as follows: RT alone, 56% and 43%; surgery and RT, 94% and 91%; and overall, 77% and 69%. Multivariate analysis of local control revealed that T stage ( p = .0101) and treatment group ( p = .0008) significantly influenced this endpoint. The 5-and 10-year rates of distant metastases-free survival were 80% and 73%. The 5-and 10-year absolute survival rates were as follows: RT alone, 57% and 42%; surgery and RT, 77% and 55%; and overall, 68% and 49%. Multivariate analysis of absolute survival revealed that T stage ( p = .0043) and clinical nerve invasion ( p = .0011) significantly influenced this endpoint. The 5-and 10-year causespecific survival rates were as follows: RT alone, 65% and 48%; surgery and RT, 81% and 71%; and overall, 74% and 61%. Multivariate analysis revealed that T stage ( p = .0008) and clinical nerve invasion ( p = .0005) significantly influenced causespecific survival.Conclusions. The optimal treatment for patients with adenoid cystic carcinoma is surgery and adjuvant RT. A significant proportion of patients with incompletely resectable disease are cured after RT alone. Improvements in locoregional control are offset, in part, by the relatively high incidence of distant metastases.

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Section: Methodsmentioning

confidence: 99%

Radiotherapy alone or combined with surgery for adenoid cystic carcinoma of the head and neck

et al. 2004

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“…Furthermore, we changed the agent for intraarterial infusion from carboplatin to cisplatin in an effort to improve the local control rate in October 2002. This is an improved technique of the Robbins et al method (Robbins et al, 1994(Robbins et al, , 2000, whereby an infusion dose of cisplatin was increased by infusing sodium thiosulphate, which is a neutralising agent of cisplatin, from a vein at the time of intra-arterial infusion of cisplatin.…”

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confidence: 99%

Intra-arterial chemoradiotherapy for locally advanced oral cavity cancer: analysis of therapeutic results in134 cases

et al. 2008

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The objective of this study was to investigate the therapeutic results of arterial injection therapy via the superficial temporal artery for 134 cases of stages III and IV (M0) oral cavity cancer retrospectively, and to clarify the prognostic factors. We administered intraarterial chemoradiotherapy by continuous infusion of carboplatin in 65 cases from January 1993 to July 2002. Systemic chemotherapy was performed on 26 cases at the same time. We administered intra-arterial chemoradiotherapy by cisplatin with sodium thiosulphate in 69 cases from October 2002 to December 2006. Systemic chemotherapy was performed on 48 cases at the same time. The 3-year local control rate was 68.6% (T2-3: 77.9%; T4: 51.3%), and the 3-year survival rate was 53.9% (stage III: 62.9%; stage IV: 45.3%). Regarding the results of multivariate analysis of survival rates, age (o65), selective intra-arterial infusion, and the use of cisplatin as an agent for intra-arterial infusion were significant factors. The therapeutic results of intra-arterial chemoradiotherapy via the superficial temporal artery were not inferior to the results of surgery. In particular, the results of arterial injection therapy by cisplatin with sodium thiosulphate were excellent, so we believe that it will be a new therapy for advanced oral cavity cancer.

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“…At concentrations higher than 1 mg ml 71 precipitation occurs and cisplatin is not dissolved totally. The use of a concentrated injection seemed justified for two reasons: the absolute dose of cisplatin remained the same as in the well established settings of intra-arterial chemotherapy of more than 300 head and neck cancer patients (Kovács et al, 1999;Robbins et al, 2000), and highly concentrated mixtures of cisplatin with embolizing agents with same or larger particle diameters were used for decades in the treatment of patients with liver cancer and metastases (Tellez et al, 1998;Yamamoto et al, 2000). The high concentrations up to 10 mg cisplatin in 1 ml lipiodol (Yamamoto et al, 2000) or other embolizing agents were empirically motivated and had no pharmacological foundation.…”

Section: Clinicalmentioning

confidence: 99%

“…These small vessels have a low flow (about 120 ml min 71 ) which additionally raises drug targeting. This therapeutic approach in head and neck SCC showed good results with respect to response and toxicity (n=4300 patients (Kovács et al, 1999;Robbins et al, 2000). Another method of increasing the regional advantage is the reduction or stop of blood flow using microcapsules (Kato et al, 1996) or embolizing agents (Araki et al, 1989) resulting in longer tumour residence time, enhancement of first-pass extraction of the drug, and also hypoxic necrosis which is intended.…”

mentioning

confidence: 99%

Monocomponent chemoembolization in oral and oropharyngeal cancer using an aqueous crystal suspension of cisplatin

Kovács

Obitz

2002

Br J Cancer

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Intensification of intra-arterial chemotherapy with high-dose cisplatin and concomitant reduction of toxicity under the conditions of the head and neck was aimed at by combination of antineoplastic activity and embolizing effect in the same pharmacon. A cisplatin suspension in normal saline (5 mg in 1 ml) with precipitation of microembolizing cisplatin crystals was prepared. No additional pharmacons. Cisplatin dosage was 150 mg m 72 , maximum absolute dose 300 mg, maximum amount of fluid 60 ml. Thirty patients (UICC-Classification of tumours: I/2 patients, II/6, III/2; IV/20) were treated in a neoadjuvant setting with superselective chemoembolization using the cisplatin suspension. A control group (n=30) with the same tumour and nodal staging was treated with a usual cisplatin solution (150 mg m 72 dissolved in 500 ml saline). In both groups, parallel intravenous infusion of sodium thiosulphate (9 g m 72 ). Endpoints were toxicity and response. Continuation of treatment by surgery or radiation. Overall remission was 70% in the study group and 46.7% in the control group after one cycle respectively. Systemic side-effects were very low (grade I WHO) in both groups. Side-effects were found to be similar to post-embolization syndrome (swelling, mild to moderate pain, leucocytosis without fever) in the study group. Chemoembolization in the head and neck area can be carried out routinely using this method.

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Targeted chemoradiation for advanced head and neck cancer: Analysis of 213 patients

Cited by 68 publications

References 0 publications

Radiotherapy alone or combined with surgery for adenoid cystic carcinoma of the head and neck

Radiotherapy alone or combined with surgery for adenoid cystic carcinoma of the head and neck

Intra-arterial chemoradiotherapy for locally advanced oral cavity cancer: analysis of therapeutic results in134 cases

Monocomponent chemoembolization in oral and oropharyngeal cancer using an aqueous crystal suspension of cisplatin

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