Concurrent chemotherapy and “concomitant boost” radiotherapy for unresectable head and neck cancer

• Published in: American journal of otolaryngology 2000-09, Vol.21 (5), p.306-311
• Main Authors: Teh, Bin S., Monga, Uma, Thornby, Jack, Gressot, Laurent, Parke, Robert B., Donovan, Donald T.
• Format: Article
• Language: English
• Subjects: Antineoplastic Agents - therapeutic use; Biological and medical sciences; Combined Modality Therapy; Diseases of the upper aerodigestive tract; Ent and stomatology; Follow-Up Studies; Head and Neck Neoplasms - drug therapy; Head and Neck Neoplasms - radiotherapy; Humans; Male; Medical sciences; Middle Aged; Neoplasm Staging; Otorhinolaryngology (head neck, general aspects and miscellaneous); Otorhinolaryngology. Stomatology; Radiotherapy. Instrumental treatment. Physiotherapy. Reeducation. Rehabilitation, orthophony, crenotherapy. Diet therapy and various other treatments (general aspects); Retrospective Studies; Tumors
• ISSN: 0196-0709; 1532-818X
• DOI: 10.1053/ajot.2000.0210306

Purpose: For patients with advanced head and neck cancer, various combined chemoradiotherapy regimens have been used to improve local control. This study was carried out to assess the outcome of concomitant chemotherapy with a “concomitant boost” radiotherapy in the treatment of advanced unresectable head and neck cancer patients. Materials and Methods: Forty-eight patients were treated with combined chemoradiotherapy between the years of 1990 and 1995. Cisplatinum (100 mg/m2) was given intravenously during week 1 and week 5. A “concomitant boost” external beam radiotherapy approach was used with twice-daily treatment delivered during the last 2 weeks. A total of 70 Gy was delivered over 6 weeks. Median follow-up was 23.5 months (2-79 months). Results: Thirty-one (65%) and 17 (35%) patients achieved complete and partial response, respectively. Median survival in complete responders has not been reached. Overall survival at 2 years, 3 years, and 5 years were 58.7%, 52.8%, and 42.4%, respectively. Median overall survival was 38.8 months. Acute confluent mucositis (Radiation Therapy Oncology [RTOG] grade 3) developed in 50% of patients, but there was no severe long-term treatment-related toxicity. Conclusion:This combined chemoradiotherapy approach is safe and efficacious for advanced unresectable head and neck cancer. Treatment-related toxicity was acceptable with 50% of patients developing acute confluent mucositis. There was no severe long-term treatment-related toxicity. (AM J Otolaryngol 2000;21:306-311. Copyright © 2000 by W.B. Saunders Company)