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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All Science Journal Classification (ASJC) codes

  • Oncology
  • Cancer Research

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