Concurrent paclitaxel and radiation in the treatment of locally advanced head and neck cancer

J. B. Sunwoo, L. L. Herscher, G. S. Kroog, Giovana Thomas, F. G. Ondrey, D. C. Duffey, B. I. Solomon, C. Boss, P. S. Albert, L. McCullugh, S. Rudy, C. Muir, S. Zhai, W. D. Figg, J. A. Cook, J. B. Mitchell, C. Van Waes

Research output: Contribution to journalArticle

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Abstract

Purpose: To determine the feasibility of an organ preservation regimen consisting of infusional paclitaxel administered concurrently with radiotherapy to patients with locally advanced head and neck squamous cell cacinoma (HNSCC).Patients and Methods: Thirty-three previously untreated patients with stage III or IV tumors were enrolled onto the study. Paclitaxel was administered as a 120-hour continuous infusion every 3 weeks during the course of radiation therapy. Sixteen patients received a paclitaxel dose of 105 mg/m2, and 17 patients received 120 mg/m2. Radiation was delivered in a standard format at 1.8 Gy/d to a total dose of 70.2 to 72 Gy. Results: Three months after therapy, a 76% complete response (CR) at the primary site and a 70% overall CR was achieved. At 36 months, locoregional control was 55.7%, overall survival was 57.8%, and disease-free survival was 51.1%. The median survival duration for all 33 patients was greater than 50 months at the time of this report. Local toxicities including mucositis, dysphagia, and skin reactions were severe but tolerable. All patients retained functional speech, and all but four patients were swallowing food 3 months after treatment. Steady-state plasma concentrations for paclitaxel were not achieved during a 120-hour infusion, suggesting a nonlinear process. Tumor volume quantified by pretreatment computerized tomography imaging was associated with likelihood of response and survival. Conclusion: Paclitaxel administered as a 120-hour continuous infusion in combination with radiotherapy is a feasible and promising treatment for patients with advanced HNSCC.

Original languageEnglish
Pages (from-to)800-811
Number of pages12
JournalJournal of Clinical Oncology
Volume19
Issue number3
StatePublished - Feb 1 2001
Externally publishedYes

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Head and Neck Neoplasms
Paclitaxel
Radiation
Radiotherapy
Therapeutics
Survival
Neck
Epithelial Cells
Head
Organ Preservation
Mucositis
Deglutition
Deglutition Disorders
Tumor Burden
Disease-Free Survival
Tomography
Food
Skin

ASJC Scopus subject areas

  • Cancer Research
  • Oncology

Cite this

Sunwoo, J. B., Herscher, L. L., Kroog, G. S., Thomas, G., Ondrey, F. G., Duffey, D. C., ... Van Waes, C. (2001). Concurrent paclitaxel and radiation in the treatment of locally advanced head and neck cancer. Journal of Clinical Oncology, 19(3), 800-811.

Concurrent paclitaxel and radiation in the treatment of locally advanced head and neck cancer. / Sunwoo, J. B.; Herscher, L. L.; Kroog, G. S.; Thomas, Giovana; Ondrey, F. G.; Duffey, D. C.; Solomon, B. I.; Boss, C.; Albert, P. S.; McCullugh, L.; Rudy, S.; Muir, C.; Zhai, S.; Figg, W. D.; Cook, J. A.; Mitchell, J. B.; Van Waes, C.

In: Journal of Clinical Oncology, Vol. 19, No. 3, 01.02.2001, p. 800-811.

Research output: Contribution to journalArticle

Sunwoo, JB, Herscher, LL, Kroog, GS, Thomas, G, Ondrey, FG, Duffey, DC, Solomon, BI, Boss, C, Albert, PS, McCullugh, L, Rudy, S, Muir, C, Zhai, S, Figg, WD, Cook, JA, Mitchell, JB & Van Waes, C 2001, 'Concurrent paclitaxel and radiation in the treatment of locally advanced head and neck cancer', Journal of Clinical Oncology, vol. 19, no. 3, pp. 800-811.
Sunwoo JB, Herscher LL, Kroog GS, Thomas G, Ondrey FG, Duffey DC et al. Concurrent paclitaxel and radiation in the treatment of locally advanced head and neck cancer. Journal of Clinical Oncology. 2001 Feb 1;19(3):800-811.
Sunwoo, J. B. ; Herscher, L. L. ; Kroog, G. S. ; Thomas, Giovana ; Ondrey, F. G. ; Duffey, D. C. ; Solomon, B. I. ; Boss, C. ; Albert, P. S. ; McCullugh, L. ; Rudy, S. ; Muir, C. ; Zhai, S. ; Figg, W. D. ; Cook, J. A. ; Mitchell, J. B. ; Van Waes, C. / Concurrent paclitaxel and radiation in the treatment of locally advanced head and neck cancer. In: Journal of Clinical Oncology. 2001 ; Vol. 19, No. 3. pp. 800-811.
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abstract = "Purpose: To determine the feasibility of an organ preservation regimen consisting of infusional paclitaxel administered concurrently with radiotherapy to patients with locally advanced head and neck squamous cell cacinoma (HNSCC).Patients and Methods: Thirty-three previously untreated patients with stage III or IV tumors were enrolled onto the study. Paclitaxel was administered as a 120-hour continuous infusion every 3 weeks during the course of radiation therapy. Sixteen patients received a paclitaxel dose of 105 mg/m2, and 17 patients received 120 mg/m2. Radiation was delivered in a standard format at 1.8 Gy/d to a total dose of 70.2 to 72 Gy. Results: Three months after therapy, a 76{\%} complete response (CR) at the primary site and a 70{\%} overall CR was achieved. At 36 months, locoregional control was 55.7{\%}, overall survival was 57.8{\%}, and disease-free survival was 51.1{\%}. The median survival duration for all 33 patients was greater than 50 months at the time of this report. Local toxicities including mucositis, dysphagia, and skin reactions were severe but tolerable. All patients retained functional speech, and all but four patients were swallowing food 3 months after treatment. Steady-state plasma concentrations for paclitaxel were not achieved during a 120-hour infusion, suggesting a nonlinear process. Tumor volume quantified by pretreatment computerized tomography imaging was associated with likelihood of response and survival. Conclusion: Paclitaxel administered as a 120-hour continuous infusion in combination with radiotherapy is a feasible and promising treatment for patients with advanced HNSCC.",
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AU - Sunwoo, J. B.

AU - Herscher, L. L.

AU - Kroog, G. S.

AU - Thomas, Giovana

AU - Ondrey, F. G.

AU - Duffey, D. C.

AU - Solomon, B. I.

AU - Boss, C.

AU - Albert, P. S.

AU - McCullugh, L.

AU - Rudy, S.

AU - Muir, C.

AU - Zhai, S.

AU - Figg, W. D.

AU - Cook, J. A.

AU - Mitchell, J. B.

AU - Van Waes, C.

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N2 - Purpose: To determine the feasibility of an organ preservation regimen consisting of infusional paclitaxel administered concurrently with radiotherapy to patients with locally advanced head and neck squamous cell cacinoma (HNSCC).Patients and Methods: Thirty-three previously untreated patients with stage III or IV tumors were enrolled onto the study. Paclitaxel was administered as a 120-hour continuous infusion every 3 weeks during the course of radiation therapy. Sixteen patients received a paclitaxel dose of 105 mg/m2, and 17 patients received 120 mg/m2. Radiation was delivered in a standard format at 1.8 Gy/d to a total dose of 70.2 to 72 Gy. Results: Three months after therapy, a 76% complete response (CR) at the primary site and a 70% overall CR was achieved. At 36 months, locoregional control was 55.7%, overall survival was 57.8%, and disease-free survival was 51.1%. The median survival duration for all 33 patients was greater than 50 months at the time of this report. Local toxicities including mucositis, dysphagia, and skin reactions were severe but tolerable. All patients retained functional speech, and all but four patients were swallowing food 3 months after treatment. Steady-state plasma concentrations for paclitaxel were not achieved during a 120-hour infusion, suggesting a nonlinear process. Tumor volume quantified by pretreatment computerized tomography imaging was associated with likelihood of response and survival. Conclusion: Paclitaxel administered as a 120-hour continuous infusion in combination with radiotherapy is a feasible and promising treatment for patients with advanced HNSCC.

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