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 language | English |
|---|---|
| Pages (from-to) | 266-276 |
| Number of pages | 11 |
| Journal | Cancer |
| Volume | 80 |
| Issue number | 2 |
| DOIs | |
| State | Published - Jul 15 1997 |
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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 journal › Article
}
TY - JOUR
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
UR - http://www.scopus.com/inward/record.url?scp=0030959666&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=0030959666&partnerID=8YFLogxK
U2 - 10.1002/(SICI)1097-0142(19970715)80:2<266::AID-CNCR15>3.0.CO;2-S
DO - 10.1002/(SICI)1097-0142(19970715)80:2<266::AID-CNCR15>3.0.CO;2-S
M3 - Article
VL - 80
SP - 266
EP - 276
JO - Cancer
JF - Cancer
SN - 0008-543X
IS - 2
ER -