Taxane-containing induction chemotherapy followed by definitive chemoradiotherapy. Outcome in patients with locally advanced head and neck cancer

Brömme, J. O.; Schmücking, M.; Arnold, A.; Giger, R.; Rauch, D.; Leiser, D.; Plasswilm, L.; Geretschläger, A.; Ghadjar, P.; Aebersold, D. M. (2013). Taxane-containing induction chemotherapy followed by definitive chemoradiotherapy. Outcome in patients with locally advanced head and neck cancer. Strahlentherapie und Onkologie, 189(8), pp. 618-624. Heidelberg: Springer Berlin Heidelberg 10.1007/s00066-013-0397-z

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BACKGROUND

Induction chemotherapy followed by definitive chemoradiotherapy is an intensified treatment approach for locally advanced squamous cell carcinoma of the head and neck (HNSCC) that might be associated with high rates of toxicity.

MATERIALS AND METHODS

The data of 40 consecutive patients who underwent induction chemotherapy with docetaxel-containing regimens followed by intensity-modulated radiotherapy (IMRT) and concomitant systemic therapy for unresectable locally advanced HNSCC were retrospectively analyzed. Primary objectives were RT-related acute and late toxicity. Secondary objectives were response to induction chemotherapy, locoregional recurrence-free survival (LRRFS), overall survival (OS), and influencing factors for LRRFS and OS.

RESULTS

The median follow-up for surviving patients was 21 months (range, 2-53 months). Patients received a median of three cycles of induction chemotherapy followed by IMRT to 72 Gy. Three patients died during induction chemotherapy and one during chemoradiotherapy. Acute RT-related toxicity was of grade 3 and 4 in 72 and 3 % of patients, respectively, mainly dysphagia and dermatitis. Late RT-related toxicity was mainly xerostomia and bone/cartilage necrosis and was of grade 3 and 4 in 15 % of patients. One- and 2-year LRRFS and OS were 72 and 49 % and 77 and 71 %, respectively.

CONCLUSION

Induction chemotherapy followed by chemoradiotherapy using IMRT was associated with a high rate of severe acute and late RT-related toxicities in this selected patient cohort. Four patients were lost because of fatal complications. Induction chemotherapy did not compromise the delivery of full-dose RT; however, the use of three cycles of concomitant cisplatin was impaired.

Item Type:

Journal Article (Original Article)

Division/Institute:

04 Faculty of Medicine > Department of Haematology, Oncology, Infectious Diseases, Laboratory Medicine and Hospital Pharmacy (DOLS) > Clinic of Radiation Oncology
04 Faculty of Medicine > Department of Head Organs and Neurology (DKNS) > Clinic of Ear, Nose and Throat Disorders (ENT)
04 Faculty of Medicine > Department of Haematology, Oncology, Infectious Diseases, Laboratory Medicine and Hospital Pharmacy (DOLS) > Clinic of Medical Oncology

UniBE Contributor:

Brömme, Jens, Schmücking, Michael, Arnold, Andreas Michael, Giger, Roland, Rauch, Daniel, Leiser, Dominic, Plasswilm, Ludwig, Geretschläger, Andreas, Ghadjar, Pirus, Aebersold, Daniel Matthias

Subjects:

600 Technology > 610 Medicine & health
700 Arts > 790 Sports, games & entertainment

ISSN:

0179-7158

Publisher:

Springer Berlin Heidelberg

Language:

Multilingual

Submitter:

Beatrice Scheidegger

Date Deposited:

17 Apr 2014 09:00

Last Modified:

02 Mar 2023 23:23

Publisher DOI:

10.1007/s00066-013-0397-z

PubMed ID:

23821138

BORIS DOI:

10.7892/boris.38929

URI:

https://boris.unibe.ch/id/eprint/38929

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