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Concurrent intra-arterial carboplatin administration and radiation therapy for the treatment of advanced head and neck squamous cell carcinoma: short term results.

Bertino G, Occhini A, Falco CE, Porta C, Corbella F, Colombo S, Balcet V, Morbini P, Zappoli F, Azzaretti A, Rodolico G, Tinelli C, Benazzo M - BMC Cancer (2009)

Bottom Line: The aim of the present study was to evaluate the survival, efficacy and safety of a modified RADPLAT-like protocol using carboplatin instead of cisplatin.Forty-four (98%) of the 45 patients who completed the protocol and 10 (91%) of the 11 who did not, were free of disease at the end of the treatment, for a comprehensive 96% of CR overall.Haematological and non-haematological toxicities are virtually similar, but carboplatin has the advantage in that it is not nephrotoxic and can be used at very high doses without any significant increase in the extent of side effects.

View Article: PubMed Central - HTML - PubMed

Affiliation: Department of Otolaryngology Head Neck Surgery, University of Pavia, IRCCS Policlinico S, Matteo Foundation, P.le Golgi 2, 27100 Pavia, Italy. giulia.bertino@tin.it

ABSTRACT

Background: The aim of the present study was to evaluate the survival, efficacy and safety of a modified RADPLAT-like protocol using carboplatin instead of cisplatin.

Methods: Fifty-six patients with primary head and neck squamous cell carcinoma received 4 cycles of intra-arterial carboplatin (350 mg/m2 per cycle every 2 weeks), with concurrent three-dimensional conformal radiation therapy.

Results: Two major and 4 minor complications were observed. Forty-five of the 56 patients (80%) completed the protocol, while 11 (20%) patients had to discontinue the intra-arterial infusions due to the occurrence of severe haematological toxicity, but were able to complete radiotherapy. Forty-four (98%) of the 45 patients who completed the protocol and 10 (91%) of the 11 who did not, were free of disease at the end of the treatment, for a comprehensive 96% of CR overall. After a median 23.55 months (range: 2 to 58 months) of follow-up, 40 patients (71%) are alive and disease-free, 1 (2%) is alive but affected by disease and 15 (27%) have died of the disease or other causes.

Conclusion: Intra-arterial carboplatin administration with concurrent three-dimensional conformal radiation therapy seems to be a promising alternative to RADPLAT in the treatment of advanced head and neck tumours. Haematological and non-haematological toxicities are virtually similar, but carboplatin has the advantage in that it is not nephrotoxic and can be used at very high doses without any significant increase in the extent of side effects.

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Follow-up. CR = complete response; NR = no response; NED = no evidence of disease; DOD = died of other disease; DWD= died with disease; T = tumour; N = neck; M = Metastasis; CHT = chemotherapy; S = surgery; AWD = alive with disease.
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Figure 3: Follow-up. CR = complete response; NR = no response; NED = no evidence of disease; DOD = died of other disease; DWD= died with disease; T = tumour; N = neck; M = Metastasis; CHT = chemotherapy; S = surgery; AWD = alive with disease.

Mentions: Only 2 of the 5 patients with recurrence at the primary site were submitted to salvage surgery, both 10 months after the beginning of the treatment; 1 of them is still alive and disease free but the other developed disease recurrence 3 years later and died of the disease. One patient with recurrence at the primary site is still alive with disease. The other 9 patients with recurrence were all submitted to systemic chemotherapy (curative or palliative) and died of disease (Figure 3).


Concurrent intra-arterial carboplatin administration and radiation therapy for the treatment of advanced head and neck squamous cell carcinoma: short term results.

Bertino G, Occhini A, Falco CE, Porta C, Corbella F, Colombo S, Balcet V, Morbini P, Zappoli F, Azzaretti A, Rodolico G, Tinelli C, Benazzo M - BMC Cancer (2009)

Follow-up. CR = complete response; NR = no response; NED = no evidence of disease; DOD = died of other disease; DWD= died with disease; T = tumour; N = neck; M = Metastasis; CHT = chemotherapy; S = surgery; AWD = alive with disease.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC2749058&req=5

Figure 3: Follow-up. CR = complete response; NR = no response; NED = no evidence of disease; DOD = died of other disease; DWD= died with disease; T = tumour; N = neck; M = Metastasis; CHT = chemotherapy; S = surgery; AWD = alive with disease.
Mentions: Only 2 of the 5 patients with recurrence at the primary site were submitted to salvage surgery, both 10 months after the beginning of the treatment; 1 of them is still alive and disease free but the other developed disease recurrence 3 years later and died of the disease. One patient with recurrence at the primary site is still alive with disease. The other 9 patients with recurrence were all submitted to systemic chemotherapy (curative or palliative) and died of disease (Figure 3).

Bottom Line: The aim of the present study was to evaluate the survival, efficacy and safety of a modified RADPLAT-like protocol using carboplatin instead of cisplatin.Forty-four (98%) of the 45 patients who completed the protocol and 10 (91%) of the 11 who did not, were free of disease at the end of the treatment, for a comprehensive 96% of CR overall.Haematological and non-haematological toxicities are virtually similar, but carboplatin has the advantage in that it is not nephrotoxic and can be used at very high doses without any significant increase in the extent of side effects.

View Article: PubMed Central - HTML - PubMed

Affiliation: Department of Otolaryngology Head Neck Surgery, University of Pavia, IRCCS Policlinico S, Matteo Foundation, P.le Golgi 2, 27100 Pavia, Italy. giulia.bertino@tin.it

ABSTRACT

Background: The aim of the present study was to evaluate the survival, efficacy and safety of a modified RADPLAT-like protocol using carboplatin instead of cisplatin.

Methods: Fifty-six patients with primary head and neck squamous cell carcinoma received 4 cycles of intra-arterial carboplatin (350 mg/m2 per cycle every 2 weeks), with concurrent three-dimensional conformal radiation therapy.

Results: Two major and 4 minor complications were observed. Forty-five of the 56 patients (80%) completed the protocol, while 11 (20%) patients had to discontinue the intra-arterial infusions due to the occurrence of severe haematological toxicity, but were able to complete radiotherapy. Forty-four (98%) of the 45 patients who completed the protocol and 10 (91%) of the 11 who did not, were free of disease at the end of the treatment, for a comprehensive 96% of CR overall. After a median 23.55 months (range: 2 to 58 months) of follow-up, 40 patients (71%) are alive and disease-free, 1 (2%) is alive but affected by disease and 15 (27%) have died of the disease or other causes.

Conclusion: Intra-arterial carboplatin administration with concurrent three-dimensional conformal radiation therapy seems to be a promising alternative to RADPLAT in the treatment of advanced head and neck tumours. Haematological and non-haematological toxicities are virtually similar, but carboplatin has the advantage in that it is not nephrotoxic and can be used at very high doses without any significant increase in the extent of side effects.

Show MeSH
Related in: MedlinePlus