High-dose superselective intra-arterial cisplatin and concomitant radiation (radplat) for advanced head and neck cancer

Background. The purpose of this study was to study the effect of intensive targeted chemoradiation in a group of patients with head and neck cancer with stage IV inoperable disease. Methods. We examined 79 patients with inoperable stage IV head and neck cancer receiving intra‐arterial infusion of hi...

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Veröffentlicht in:Head & neck 2004-06, Vol.26 (6), p.485-493
Hauptverfasser: Balm, Alfons J. M., Rasch, Coen R. N., Schornagel, Jan H., Hilgers, Frans J. M., Keus, Ronald B., Schultze-Kool, Leo, Ackerstaff, Annemieke H., Busschers, Wim, Tan, I. Bing
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container_end_page 493
container_issue 6
container_start_page 485
container_title Head & neck
container_volume 26
creator Balm, Alfons J. M.
Rasch, Coen R. N.
Schornagel, Jan H.
Hilgers, Frans J. M.
Keus, Ronald B.
Schultze-Kool, Leo
Ackerstaff, Annemieke H.
Busschers, Wim
Tan, I. Bing
description Background. The purpose of this study was to study the effect of intensive targeted chemoradiation in a group of patients with head and neck cancer with stage IV inoperable disease. Methods. We examined 79 patients with inoperable stage IV head and neck cancer receiving intra‐arterial infusion of high‐dose cisplatin (150 mg/m2) on days 2, 9, 16, and 23 concomitant with delivery of external beam radiotherapy (total dose, 70 Gy; 2 Gy, 35 fractions; 1 fraction/day for 7 weeks). Sodium thiosulfate was administered intravenously to provide effective cisplatin neutralization. Results. Four patients were not assessable. Complete local tumor response was achieved in 72 patients (91%) and a partial response in three patients. The complete response rate of neck node metastases was 90%. The 1‐ and 2‐year locoregional control rates were 82% and 69%, respectively. The median overall survival time was 2.2 years, with a 3‐year overall survival probability of 43%. Acute toxicities were as follows: grade III/IV hematologic toxicity (22%/16%), grade III/IV nephrotoxicity (0%), grade III mucositis (43%), grade III skin reactions (24%), grade III toxicity of the upper gastrointestinal tract (57%), grade III nausea (20%), and grade III subjective hearing loss (10%). Grade V toxicity (treatment‐related deaths) was 3.8%. Six (18%) of 33 patients with complete remission needed tube feeding 2 years after treatment without intercurrent salvage surgery. Conclusions. Supradose superselective intra‐arterial cisplatin and concomitant radiation is an effective organ‐preserving therapy in an unfavorable group of patients. Our series confirms encouraging results reported previously. This regimen is justified in unresectable patients despite the substantial toxicity. © 2004 Wiley Periodicals, Inc. Head Neck 26: 485–493, 2004
doi_str_mv 10.1002/hed.20006
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M. ; Rasch, Coen R. N. ; Schornagel, Jan H. ; Hilgers, Frans J. M. ; Keus, Ronald B. ; Schultze-Kool, Leo ; Ackerstaff, Annemieke H. ; Busschers, Wim ; Tan, I. Bing</creator><creatorcontrib>Balm, Alfons J. M. ; Rasch, Coen R. N. ; Schornagel, Jan H. ; Hilgers, Frans J. M. ; Keus, Ronald B. ; Schultze-Kool, Leo ; Ackerstaff, Annemieke H. ; Busschers, Wim ; Tan, I. Bing</creatorcontrib><description>Background. The purpose of this study was to study the effect of intensive targeted chemoradiation in a group of patients with head and neck cancer with stage IV inoperable disease. Methods. We examined 79 patients with inoperable stage IV head and neck cancer receiving intra‐arterial infusion of high‐dose cisplatin (150 mg/m2) on days 2, 9, 16, and 23 concomitant with delivery of external beam radiotherapy (total dose, 70 Gy; 2 Gy, 35 fractions; 1 fraction/day for 7 weeks). Sodium thiosulfate was administered intravenously to provide effective cisplatin neutralization. Results. Four patients were not assessable. Complete local tumor response was achieved in 72 patients (91%) and a partial response in three patients. The complete response rate of neck node metastases was 90%. The 1‐ and 2‐year locoregional control rates were 82% and 69%, respectively. The median overall survival time was 2.2 years, with a 3‐year overall survival probability of 43%. Acute toxicities were as follows: grade III/IV hematologic toxicity (22%/16%), grade III/IV nephrotoxicity (0%), grade III mucositis (43%), grade III skin reactions (24%), grade III toxicity of the upper gastrointestinal tract (57%), grade III nausea (20%), and grade III subjective hearing loss (10%). Grade V toxicity (treatment‐related deaths) was 3.8%. Six (18%) of 33 patients with complete remission needed tube feeding 2 years after treatment without intercurrent salvage surgery. Conclusions. Supradose superselective intra‐arterial cisplatin and concomitant radiation is an effective organ‐preserving therapy in an unfavorable group of patients. Our series confirms encouraging results reported previously. This regimen is justified in unresectable patients despite the substantial toxicity. © 2004 Wiley Periodicals, Inc. 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M.</creatorcontrib><creatorcontrib>Rasch, Coen R. N.</creatorcontrib><creatorcontrib>Schornagel, Jan H.</creatorcontrib><creatorcontrib>Hilgers, Frans J. M.</creatorcontrib><creatorcontrib>Keus, Ronald B.</creatorcontrib><creatorcontrib>Schultze-Kool, Leo</creatorcontrib><creatorcontrib>Ackerstaff, Annemieke H.</creatorcontrib><creatorcontrib>Busschers, Wim</creatorcontrib><creatorcontrib>Tan, I. Bing</creatorcontrib><title>High-dose superselective intra-arterial cisplatin and concomitant radiation (radplat) for advanced head and neck cancer</title><title>Head &amp; neck</title><addtitle>Head Neck</addtitle><description>Background. The purpose of this study was to study the effect of intensive targeted chemoradiation in a group of patients with head and neck cancer with stage IV inoperable disease. Methods. We examined 79 patients with inoperable stage IV head and neck cancer receiving intra‐arterial infusion of high‐dose cisplatin (150 mg/m2) on days 2, 9, 16, and 23 concomitant with delivery of external beam radiotherapy (total dose, 70 Gy; 2 Gy, 35 fractions; 1 fraction/day for 7 weeks). Sodium thiosulfate was administered intravenously to provide effective cisplatin neutralization. Results. Four patients were not assessable. Complete local tumor response was achieved in 72 patients (91%) and a partial response in three patients. The complete response rate of neck node metastases was 90%. The 1‐ and 2‐year locoregional control rates were 82% and 69%, respectively. The median overall survival time was 2.2 years, with a 3‐year overall survival probability of 43%. Acute toxicities were as follows: grade III/IV hematologic toxicity (22%/16%), grade III/IV nephrotoxicity (0%), grade III mucositis (43%), grade III skin reactions (24%), grade III toxicity of the upper gastrointestinal tract (57%), grade III nausea (20%), and grade III subjective hearing loss (10%). Grade V toxicity (treatment‐related deaths) was 3.8%. Six (18%) of 33 patients with complete remission needed tube feeding 2 years after treatment without intercurrent salvage surgery. Conclusions. Supradose superselective intra‐arterial cisplatin and concomitant radiation is an effective organ‐preserving therapy in an unfavorable group of patients. Our series confirms encouraging results reported previously. This regimen is justified in unresectable patients despite the substantial toxicity. © 2004 Wiley Periodicals, Inc. 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Stomatology</topic><topic>Radiotherapy, Adjuvant - adverse effects</topic><topic>Skin Diseases - chemically induced</topic><topic>Treatment Outcome</topic><topic>Tumors</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Balm, Alfons J. M.</creatorcontrib><creatorcontrib>Rasch, Coen R. N.</creatorcontrib><creatorcontrib>Schornagel, Jan H.</creatorcontrib><creatorcontrib>Hilgers, Frans J. M.</creatorcontrib><creatorcontrib>Keus, Ronald B.</creatorcontrib><creatorcontrib>Schultze-Kool, Leo</creatorcontrib><creatorcontrib>Ackerstaff, Annemieke H.</creatorcontrib><creatorcontrib>Busschers, Wim</creatorcontrib><creatorcontrib>Tan, I. Bing</creatorcontrib><collection>Istex</collection><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><jtitle>Head &amp; neck</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Balm, Alfons J. M.</au><au>Rasch, Coen R. N.</au><au>Schornagel, Jan H.</au><au>Hilgers, Frans J. M.</au><au>Keus, Ronald B.</au><au>Schultze-Kool, Leo</au><au>Ackerstaff, Annemieke H.</au><au>Busschers, Wim</au><au>Tan, I. Bing</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>High-dose superselective intra-arterial cisplatin and concomitant radiation (radplat) for advanced head and neck cancer</atitle><jtitle>Head &amp; neck</jtitle><addtitle>Head Neck</addtitle><date>2004-06</date><risdate>2004</risdate><volume>26</volume><issue>6</issue><spage>485</spage><epage>493</epage><pages>485-493</pages><issn>1043-3074</issn><eissn>1097-0347</eissn><abstract>Background. The purpose of this study was to study the effect of intensive targeted chemoradiation in a group of patients with head and neck cancer with stage IV inoperable disease. Methods. We examined 79 patients with inoperable stage IV head and neck cancer receiving intra‐arterial infusion of high‐dose cisplatin (150 mg/m2) on days 2, 9, 16, and 23 concomitant with delivery of external beam radiotherapy (total dose, 70 Gy; 2 Gy, 35 fractions; 1 fraction/day for 7 weeks). Sodium thiosulfate was administered intravenously to provide effective cisplatin neutralization. Results. Four patients were not assessable. Complete local tumor response was achieved in 72 patients (91%) and a partial response in three patients. The complete response rate of neck node metastases was 90%. The 1‐ and 2‐year locoregional control rates were 82% and 69%, respectively. The median overall survival time was 2.2 years, with a 3‐year overall survival probability of 43%. Acute toxicities were as follows: grade III/IV hematologic toxicity (22%/16%), grade III/IV nephrotoxicity (0%), grade III mucositis (43%), grade III skin reactions (24%), grade III toxicity of the upper gastrointestinal tract (57%), grade III nausea (20%), and grade III subjective hearing loss (10%). Grade V toxicity (treatment‐related deaths) was 3.8%. Six (18%) of 33 patients with complete remission needed tube feeding 2 years after treatment without intercurrent salvage surgery. Conclusions. Supradose superselective intra‐arterial cisplatin and concomitant radiation is an effective organ‐preserving therapy in an unfavorable group of patients. Our series confirms encouraging results reported previously. This regimen is justified in unresectable patients despite the substantial toxicity. © 2004 Wiley Periodicals, Inc. Head Neck 26: 485–493, 2004</abstract><cop>Hoboken</cop><pub>Wiley Subscription Services, Inc., A Wiley Company</pub><pmid>15162349</pmid><doi>10.1002/hed.20006</doi><tpages>9</tpages><oa>free_for_read</oa></addata></record>
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subjects Adult
advanced head and neck cancer
Aged
Antineoplastic Agents - administration & dosage
Antineoplastic Agents - adverse effects
Biological and medical sciences
chemoradiation
Cisplatin - administration & dosage
Cisplatin - adverse effects
Dose-Response Relationship, Drug
Female
Gastrointestinal Diseases - chemically induced
Head and Neck Neoplasms - mortality
Head and Neck Neoplasms - pathology
Head and Neck Neoplasms - therapy
Hearing Loss - chemically induced
Heart Failure - chemically induced
Hematologic Diseases - chemically induced
Humans
Infusions, Intra-Arterial
Ischemic Attack, Transient - chemically induced
Lymphatic Metastasis
Male
Medical sciences
Middle Aged
Mouth Mucosa - drug effects
Nausea - chemically induced
Otorhinolaryngology (head neck, general aspects and miscellaneous)
Otorhinolaryngology. Stomatology
Radiotherapy, Adjuvant - adverse effects
Skin Diseases - chemically induced
Treatment Outcome
Tumors
title High-dose superselective intra-arterial cisplatin and concomitant radiation (radplat) for advanced head and neck cancer
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