Concurrent radiation therapy and chemotherapy for locally unresectable squamous cell head and neck cancer

An Eastern Cooperative Oncology Group pilot study

D. J. Adelstein, L. A. Kalish, G. L. Adams, Henry Wagner Jr., M. M. Oken, S. C. Remick, E. G. Mansour, R. E. Hoselow

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Abstract

Purpose: The feasibility and success of an intensive chemoradiotherapeutic protocol for patients with locally advanced, unresectable squamous cell head and neck cancer was tested in this limited-institution, Eastern Cooperative Oncology Group phase II pilot study. Materials and Methods: Between December 1987 and September 1989, 57 patients were entered onto this trial. The treatment protocol consisted of three courses of a 4-day continuous fluorouracil infusion, a single cisplatin bolus injection, and concurrent split-course radiotherapy. After 30 Gy of radiation and two chemotherapy courses, patients were evaluated for response and for the possibility of surgical resection. Results: Fifty-five of 57 registered patients are assessable for toxicity and 52 are assessable for response and survival. Toxicity was significant, but tolerable, although there were three toxic deaths. A complete response to this treatment was ultimately achieved by 77% of patients. Twenty-four patients remain relapse-free. The projected Kaplan- Meier 4-year relapse-free survival rate is 45% and the overall survival rate is 49%. Median relapse-free and overall survival durations are 26 and 37 months, respectively. Of the 28 treatment failures, 79% were locoregional. Fourteen patients underwent surgery. Six remain relapse-free. Conclusion: This aggressive concurrent chemoradiotherapy protocol appears feasible within a cooperative group. Treatment results are promising and appear durable. A randomized phase III clinical trial is currently underway.

Original languageEnglish (US)
Pages (from-to)2136-2142
Number of pages7
JournalJournal of Clinical Oncology
Volume11
Issue number11
DOIs
StatePublished - Jan 1 1993

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Squamous Cell Neoplasms
Head and Neck Neoplasms
Radiotherapy
Drug Therapy
Recurrence
Survival Rate
Radiation Dosage
Phase III Clinical Trials
Survival
Poisons
Chemoradiotherapy
Clinical Protocols
Treatment Failure
Fluorouracil
Cisplatin
Randomized Controlled Trials
Injections
Therapeutics

All Science Journal Classification (ASJC) codes

  • Oncology
  • Cancer Research

Cite this

Adelstein, D. J. ; Kalish, L. A. ; Adams, G. L. ; Wagner Jr., Henry ; Oken, M. M. ; Remick, S. C. ; Mansour, E. G. ; Hoselow, R. E. / Concurrent radiation therapy and chemotherapy for locally unresectable squamous cell head and neck cancer : An Eastern Cooperative Oncology Group pilot study. In: Journal of Clinical Oncology. 1993 ; Vol. 11, No. 11. pp. 2136-2142.
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abstract = "Purpose: The feasibility and success of an intensive chemoradiotherapeutic protocol for patients with locally advanced, unresectable squamous cell head and neck cancer was tested in this limited-institution, Eastern Cooperative Oncology Group phase II pilot study. Materials and Methods: Between December 1987 and September 1989, 57 patients were entered onto this trial. The treatment protocol consisted of three courses of a 4-day continuous fluorouracil infusion, a single cisplatin bolus injection, and concurrent split-course radiotherapy. After 30 Gy of radiation and two chemotherapy courses, patients were evaluated for response and for the possibility of surgical resection. Results: Fifty-five of 57 registered patients are assessable for toxicity and 52 are assessable for response and survival. Toxicity was significant, but tolerable, although there were three toxic deaths. A complete response to this treatment was ultimately achieved by 77{\%} of patients. Twenty-four patients remain relapse-free. The projected Kaplan- Meier 4-year relapse-free survival rate is 45{\%} and the overall survival rate is 49{\%}. Median relapse-free and overall survival durations are 26 and 37 months, respectively. Of the 28 treatment failures, 79{\%} were locoregional. Fourteen patients underwent surgery. Six remain relapse-free. Conclusion: This aggressive concurrent chemoradiotherapy protocol appears feasible within a cooperative group. Treatment results are promising and appear durable. A randomized phase III clinical trial is currently underway.",
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Concurrent radiation therapy and chemotherapy for locally unresectable squamous cell head and neck cancer : An Eastern Cooperative Oncology Group pilot study. / Adelstein, D. J.; Kalish, L. A.; Adams, G. L.; Wagner Jr., Henry; Oken, M. M.; Remick, S. C.; Mansour, E. G.; Hoselow, R. E.

In: Journal of Clinical Oncology, Vol. 11, No. 11, 01.01.1993, p. 2136-2142.

Research output: Contribution to journalArticle

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T1 - Concurrent radiation therapy and chemotherapy for locally unresectable squamous cell head and neck cancer

T2 - An Eastern Cooperative Oncology Group pilot study

AU - Adelstein, D. J.

AU - Kalish, L. A.

AU - Adams, G. L.

AU - Wagner Jr., Henry

AU - Oken, M. M.

AU - Remick, S. C.

AU - Mansour, E. G.

AU - Hoselow, R. E.

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N2 - Purpose: The feasibility and success of an intensive chemoradiotherapeutic protocol for patients with locally advanced, unresectable squamous cell head and neck cancer was tested in this limited-institution, Eastern Cooperative Oncology Group phase II pilot study. Materials and Methods: Between December 1987 and September 1989, 57 patients were entered onto this trial. The treatment protocol consisted of three courses of a 4-day continuous fluorouracil infusion, a single cisplatin bolus injection, and concurrent split-course radiotherapy. After 30 Gy of radiation and two chemotherapy courses, patients were evaluated for response and for the possibility of surgical resection. Results: Fifty-five of 57 registered patients are assessable for toxicity and 52 are assessable for response and survival. Toxicity was significant, but tolerable, although there were three toxic deaths. A complete response to this treatment was ultimately achieved by 77% of patients. Twenty-four patients remain relapse-free. The projected Kaplan- Meier 4-year relapse-free survival rate is 45% and the overall survival rate is 49%. Median relapse-free and overall survival durations are 26 and 37 months, respectively. Of the 28 treatment failures, 79% were locoregional. Fourteen patients underwent surgery. Six remain relapse-free. Conclusion: This aggressive concurrent chemoradiotherapy protocol appears feasible within a cooperative group. Treatment results are promising and appear durable. A randomized phase III clinical trial is currently underway.

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