Hyperfractionated radiation therapy and 5-fluorouracil, cisplatin, and mitomycin-C (± granulocyte-colony stimulating factor) in the treatment of patients with locally advanced head and neck carcinoma

André A. Abitbol, Kasi S. Sridhar, Alan A. Lewin, James G. Schwade, William Raub, Aaron Wolfson, Carlos Gonzalez-Angulo, Anthony Adessa, W. Jarrard Goodwin, Arnold Markoe

Research output: Contribution to journalArticle

37 Citations (Scopus)

Abstract

BACKGROUND. The authors had previously reported preliminary results of a treatment regimen of concurrent hyperfractionated radiation therapy and chemotherapy in patients with locally advanced head and neck carcinoma that demonstrated both feasibility and high local control. In an attempt to reduce acute mucosal and hematologic toxicity, granulocyte-colony stimulating factor (G-CSF) was added during the second phase of this study. METHODS. Seventy patients (53 with Stage IV and 17 with Stage III disease) were entered between May 1988 and June 1995 into a Phase I/II trial of concurrent radiation therapy (74.4 gray (Gy) total dose; 1.20 Gy twice daily), 5- fluorouracil (1000 mg/m2/24 hours for 72 hours), and cisplatin (50 mg/m2) for 3 cycles with the addition of mitomycin C (8 mg/m2) in Cycle 2. G-CSF was added after the initial entry of 34 patients. RESULTS. At a median follow-up of 41 months (range, 12-80 months), 44 patients were alive with a projected median overall survival of 54 months. Grade 3/4 mucositis, observed in 65% of patients, was equally prevalent and prolonged in both G-CSF- treated (+) and G-CSF-naive (-) patients. Grade 3/4 leukopenia was present in 45% and 36% of G-CSF- and G-CSF+ patients, respectively. The 3-year locoregional control and cause specific survival rates were 68% and 75%, respectively. CONCLUSIONS. This regimen was feasible and effective but caused severe mucositis. No benefit was derived from the addition of G-CSF. This regimen deserves further modification to reduce acute mucositis toxicity yet maintain the high locoregional control rate.

Original languageEnglish
Pages (from-to)266-276
Number of pages11
JournalCancer
Volume80
Issue number2
DOIs
StatePublished - Jul 15 1997

Fingerprint

Mitomycin
Granulocyte Colony-Stimulating Factor
Fluorouracil
Cisplatin
Neck
Radiotherapy
Head
Carcinoma
Mucositis
Therapeutics
Leukopenia
Survival Rate
Drug Therapy
Survival

Keywords

  • Combination chemotherapy
  • Concurrent chemotherapy and radiation therapy
  • Head and neck carcinoma
  • Hyperfractionated radiation therapy

ASJC Scopus subject areas

  • Cancer Research
  • Oncology

Cite this

Hyperfractionated radiation therapy and 5-fluorouracil, cisplatin, and mitomycin-C (± granulocyte-colony stimulating factor) in the treatment of patients with locally advanced head and neck carcinoma. / Abitbol, André A.; Sridhar, Kasi S.; Lewin, Alan A.; Schwade, James G.; Raub, William; Wolfson, Aaron; Gonzalez-Angulo, Carlos; Adessa, Anthony; Goodwin, W. Jarrard; Markoe, Arnold.

In: Cancer, Vol. 80, No. 2, 15.07.1997, p. 266-276.

Research output: Contribution to journalArticle

Abitbol, André A. ; Sridhar, Kasi S. ; Lewin, Alan A. ; Schwade, James G. ; Raub, William ; Wolfson, Aaron ; Gonzalez-Angulo, Carlos ; Adessa, Anthony ; Goodwin, W. Jarrard ; Markoe, Arnold. / Hyperfractionated radiation therapy and 5-fluorouracil, cisplatin, and mitomycin-C (± granulocyte-colony stimulating factor) in the treatment of patients with locally advanced head and neck carcinoma. In: Cancer. 1997 ; Vol. 80, No. 2. pp. 266-276.
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abstract = "BACKGROUND. The authors had previously reported preliminary results of a treatment regimen of concurrent hyperfractionated radiation therapy and chemotherapy in patients with locally advanced head and neck carcinoma that demonstrated both feasibility and high local control. In an attempt to reduce acute mucosal and hematologic toxicity, granulocyte-colony stimulating factor (G-CSF) was added during the second phase of this study. METHODS. Seventy patients (53 with Stage IV and 17 with Stage III disease) were entered between May 1988 and June 1995 into a Phase I/II trial of concurrent radiation therapy (74.4 gray (Gy) total dose; 1.20 Gy twice daily), 5- fluorouracil (1000 mg/m2/24 hours for 72 hours), and cisplatin (50 mg/m2) for 3 cycles with the addition of mitomycin C (8 mg/m2) in Cycle 2. G-CSF was added after the initial entry of 34 patients. RESULTS. At a median follow-up of 41 months (range, 12-80 months), 44 patients were alive with a projected median overall survival of 54 months. Grade 3/4 mucositis, observed in 65{\%} of patients, was equally prevalent and prolonged in both G-CSF- treated (+) and G-CSF-naive (-) patients. Grade 3/4 leukopenia was present in 45{\%} and 36{\%} of G-CSF- and G-CSF+ patients, respectively. The 3-year locoregional control and cause specific survival rates were 68{\%} and 75{\%}, respectively. CONCLUSIONS. This regimen was feasible and effective but caused severe mucositis. No benefit was derived from the addition of G-CSF. This regimen deserves further modification to reduce acute mucositis toxicity yet maintain the high locoregional control rate.",
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T1 - Hyperfractionated radiation therapy and 5-fluorouracil, cisplatin, and mitomycin-C (± granulocyte-colony stimulating factor) in the treatment of patients with locally advanced head and neck carcinoma

AU - Abitbol, André A.

AU - Sridhar, Kasi S.

AU - Lewin, Alan A.

AU - Schwade, James G.

AU - Raub, William

AU - Wolfson, Aaron

AU - Gonzalez-Angulo, Carlos

AU - Adessa, Anthony

AU - Goodwin, W. Jarrard

AU - Markoe, Arnold

PY - 1997/7/15

Y1 - 1997/7/15

N2 - BACKGROUND. The authors had previously reported preliminary results of a treatment regimen of concurrent hyperfractionated radiation therapy and chemotherapy in patients with locally advanced head and neck carcinoma that demonstrated both feasibility and high local control. In an attempt to reduce acute mucosal and hematologic toxicity, granulocyte-colony stimulating factor (G-CSF) was added during the second phase of this study. METHODS. Seventy patients (53 with Stage IV and 17 with Stage III disease) were entered between May 1988 and June 1995 into a Phase I/II trial of concurrent radiation therapy (74.4 gray (Gy) total dose; 1.20 Gy twice daily), 5- fluorouracil (1000 mg/m2/24 hours for 72 hours), and cisplatin (50 mg/m2) for 3 cycles with the addition of mitomycin C (8 mg/m2) in Cycle 2. G-CSF was added after the initial entry of 34 patients. RESULTS. At a median follow-up of 41 months (range, 12-80 months), 44 patients were alive with a projected median overall survival of 54 months. Grade 3/4 mucositis, observed in 65% of patients, was equally prevalent and prolonged in both G-CSF- treated (+) and G-CSF-naive (-) patients. Grade 3/4 leukopenia was present in 45% and 36% of G-CSF- and G-CSF+ patients, respectively. The 3-year locoregional control and cause specific survival rates were 68% and 75%, respectively. CONCLUSIONS. This regimen was feasible and effective but caused severe mucositis. No benefit was derived from the addition of G-CSF. This regimen deserves further modification to reduce acute mucositis toxicity yet maintain the high locoregional control rate.

AB - BACKGROUND. The authors had previously reported preliminary results of a treatment regimen of concurrent hyperfractionated radiation therapy and chemotherapy in patients with locally advanced head and neck carcinoma that demonstrated both feasibility and high local control. In an attempt to reduce acute mucosal and hematologic toxicity, granulocyte-colony stimulating factor (G-CSF) was added during the second phase of this study. METHODS. Seventy patients (53 with Stage IV and 17 with Stage III disease) were entered between May 1988 and June 1995 into a Phase I/II trial of concurrent radiation therapy (74.4 gray (Gy) total dose; 1.20 Gy twice daily), 5- fluorouracil (1000 mg/m2/24 hours for 72 hours), and cisplatin (50 mg/m2) for 3 cycles with the addition of mitomycin C (8 mg/m2) in Cycle 2. G-CSF was added after the initial entry of 34 patients. RESULTS. At a median follow-up of 41 months (range, 12-80 months), 44 patients were alive with a projected median overall survival of 54 months. Grade 3/4 mucositis, observed in 65% of patients, was equally prevalent and prolonged in both G-CSF- treated (+) and G-CSF-naive (-) patients. Grade 3/4 leukopenia was present in 45% and 36% of G-CSF- and G-CSF+ patients, respectively. The 3-year locoregional control and cause specific survival rates were 68% and 75%, respectively. CONCLUSIONS. This regimen was feasible and effective but caused severe mucositis. No benefit was derived from the addition of G-CSF. This regimen deserves further modification to reduce acute mucositis toxicity yet maintain the high locoregional control rate.

KW - Combination chemotherapy

KW - Concurrent chemotherapy and radiation therapy

KW - Head and neck carcinoma

KW - Hyperfractionated radiation therapy

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