Targeted chemoradiation for advanced head and neck cancer

Analysis of 213 patients

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

Research output: Contribution to journalArticle

174 Citations (Scopus)

Abstract

Background. To determine the survival results, patterns of relapse, and organ preservation effects of a targeted chemoradiation protocol for patients with advanced (stage III-IV) carcinoma of the head and neck. Methods. Analysis of 213 patients with stage III-IV squamous cell carcinoma treated at UT Memphis between June 1993 and March 1998. Treatment included weekly intra-arterial infusions of cisplatin (150 mg/m 2 / week x 4) rapidly delivered to the tumor bulk, simultaneous intravenous thiosulfate for systemic drug neutralization, and conventional external-beam irradiation (180-200 cGy/fraction) to a total dose of 68-72 Gy. Results. Tumor response, toxicity, disease control above the clavicle, pattern of relapse, and survival. There were 89 events of grade III-IV toxicity and 6 treatment-related deaths (grade V). Complete response in the primary and regional sites was obtained in 171 of 213 (80%) and 92 of 151 (61%), respectively. The rate of clearance of regional disease after neck dissection was 98%. There were 51 of 195 recurrences (26%): 11 local (5.6%), 5 regional (2.6%), and 35 distant (17.9%). The Kaplan Meier plot projections for overall and cancer-related 5-year survival was 38.8% and 53.6%, respectively, whereas disease control above the clavicle was 74.3%. Conclusions. We believe this chemoradiation protocol represents an effective management scheme for patients with advanced head and neck cancer with a high rate of organ preservation and possibly improved survival.

Original languageEnglish (US)
Pages (from-to)687-693
Number of pages7
JournalHead and Neck
Volume22
Issue number7
DOIs
StatePublished - Jan 1 2000

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Head and Neck Neoplasms
Organ Preservation
Clavicle
Survival
Recurrence
Thiosulfates
Intra Arterial Infusions
Neoplasms
Neck Dissection
Cisplatin
Squamous Cell Carcinoma
Neck
Head
Carcinoma
Therapeutics
Pharmaceutical Preparations

All Science Journal Classification (ASJC) codes

  • Otorhinolaryngology

Cite this

Robbins, K. T., Kumar, P., Wong, F. S. H., Hartsell, W. F., Flick, P., Palmer, R., ... Howell, S. B. (2000). Targeted chemoradiation for advanced head and neck cancer: Analysis of 213 patients. Head and Neck, 22(7), 687-693. https://doi.org/10.1002/1097-0347(200010)22:7<687::AID-HED8>3.0.CO;2-W

Targeted chemoradiation for advanced head and neck cancer : Analysis of 213 patients. / Robbins, K. Thomas; Kumar, Parvesh; Wong, Frank S.H.; Hartsell, William F.; Flick, Pamela; Palmer, Robert; Weir, Alva; Neill, H. Barry; Murry, Thomas; Ferguson, Robert; Hanchett, Catherine; Vieira, Francisco; Bush, Andrew; Howell, Stephen B.

In: Head and Neck, Vol. 22, No. 7, 01.01.2000, p. 687-693.

Research output: Contribution to journalArticle

Robbins, KT, Kumar, P, Wong, FSH, Hartsell, WF, Flick, P, Palmer, R, Weir, A, Neill, HB, Murry, T, Ferguson, R, Hanchett, C, Vieira, F, Bush, A & Howell, SB 2000, 'Targeted chemoradiation for advanced head and neck cancer: Analysis of 213 patients', Head and Neck, vol. 22, no. 7, pp. 687-693. https://doi.org/10.1002/1097-0347(200010)22:7<687::AID-HED8>3.0.CO;2-W
Robbins, K. Thomas ; Kumar, Parvesh ; Wong, Frank S.H. ; Hartsell, William F. ; Flick, Pamela ; Palmer, Robert ; Weir, Alva ; Neill, H. Barry ; Murry, Thomas ; Ferguson, Robert ; Hanchett, Catherine ; Vieira, Francisco ; Bush, Andrew ; Howell, Stephen B. / Targeted chemoradiation for advanced head and neck cancer : Analysis of 213 patients. In: Head and Neck. 2000 ; Vol. 22, No. 7. pp. 687-693.
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T2 - Analysis of 213 patients

AU - Robbins, K. Thomas

AU - Kumar, Parvesh

AU - Wong, Frank S.H.

AU - Hartsell, William F.

AU - Flick, Pamela

AU - Palmer, Robert

AU - Weir, Alva

AU - Neill, H. Barry

AU - Murry, Thomas

AU - Ferguson, Robert

AU - Hanchett, Catherine

AU - Vieira, Francisco

AU - Bush, Andrew

AU - Howell, Stephen B.

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N2 - Background. To determine the survival results, patterns of relapse, and organ preservation effects of a targeted chemoradiation protocol for patients with advanced (stage III-IV) carcinoma of the head and neck. Methods. Analysis of 213 patients with stage III-IV squamous cell carcinoma treated at UT Memphis between June 1993 and March 1998. Treatment included weekly intra-arterial infusions of cisplatin (150 mg/m 2 / week x 4) rapidly delivered to the tumor bulk, simultaneous intravenous thiosulfate for systemic drug neutralization, and conventional external-beam irradiation (180-200 cGy/fraction) to a total dose of 68-72 Gy. Results. Tumor response, toxicity, disease control above the clavicle, pattern of relapse, and survival. There were 89 events of grade III-IV toxicity and 6 treatment-related deaths (grade V). Complete response in the primary and regional sites was obtained in 171 of 213 (80%) and 92 of 151 (61%), respectively. The rate of clearance of regional disease after neck dissection was 98%. There were 51 of 195 recurrences (26%): 11 local (5.6%), 5 regional (2.6%), and 35 distant (17.9%). The Kaplan Meier plot projections for overall and cancer-related 5-year survival was 38.8% and 53.6%, respectively, whereas disease control above the clavicle was 74.3%. Conclusions. We believe this chemoradiation protocol represents an effective management scheme for patients with advanced head and neck cancer with a high rate of organ preservation and possibly improved survival.

AB - Background. To determine the survival results, patterns of relapse, and organ preservation effects of a targeted chemoradiation protocol for patients with advanced (stage III-IV) carcinoma of the head and neck. Methods. Analysis of 213 patients with stage III-IV squamous cell carcinoma treated at UT Memphis between June 1993 and March 1998. Treatment included weekly intra-arterial infusions of cisplatin (150 mg/m 2 / week x 4) rapidly delivered to the tumor bulk, simultaneous intravenous thiosulfate for systemic drug neutralization, and conventional external-beam irradiation (180-200 cGy/fraction) to a total dose of 68-72 Gy. Results. Tumor response, toxicity, disease control above the clavicle, pattern of relapse, and survival. There were 89 events of grade III-IV toxicity and 6 treatment-related deaths (grade V). Complete response in the primary and regional sites was obtained in 171 of 213 (80%) and 92 of 151 (61%), respectively. The rate of clearance of regional disease after neck dissection was 98%. There were 51 of 195 recurrences (26%): 11 local (5.6%), 5 regional (2.6%), and 35 distant (17.9%). The Kaplan Meier plot projections for overall and cancer-related 5-year survival was 38.8% and 53.6%, respectively, whereas disease control above the clavicle was 74.3%. Conclusions. We believe this chemoradiation protocol represents an effective management scheme for patients with advanced head and neck cancer with a high rate of organ preservation and possibly improved survival.

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