Alternating chemotherapy: gemcitabine and cisplatin with concurrent radiotherapy for treatment of advanced head and neck cancer.
Oral Oncol
; 49(3): 249-54, 2013 Mar.
Article
en En
| MEDLINE
| ID: mdl-23043985
ABSTRACT
BACKGROUND:
Many studies have shown gemcitabine and cisplatin are radiosensitizers. Concurrent chemoradiation seems to be an efficient approach for treatment of advanced head and neck cancer (HNC), but toxicity is significant.OBJECTIVE:
To evaluate safety and explore efficacy of alternating chemotherapy with gemcitabine and cisplatin concurrent with radiotherapy in patients with advanced non-metastatic HNC. PATIENTS ANDMETHODS:
Twenty-eight patients diagnosed with advanced Squamous Cell Carcinomas of the Head and Neck (SCCHN) in stages III (28%), IVa (36%), and IVb (36%) were treated with gemcitabine 100mg/m(2) alternating with cisplatin 50mg/m(2) concurrent with radiotherapy at doses of 2 Gy/day until completing 70 Gy. While awaiting for concurrent treatment, eleven patients received induction chemotherapy with cisplatin 100mg/m(2) and 5-FU 1000 mg/m(2). Toxicity, especially in relation to mucositis, xerostomy, dysphagia, leucopenia and radiodermitis was evaluated.RESULTS:
5-year progression-free survival was 27.8 ± 17.2% (CI-95 0-61.5) and overall survival was 55.9 ± 11% (CI 34.4-77.5). Overall response rate was 93%; complete response was 64.3% and partial response was 28.6%. Extensive surgery for primary site was avoided in 19 patients (70.4%). Grade 3-4 adverse events were mucositis (46.4%), leucopenia (14.2%), dysphagia (25%), xerostomy (10.7%) and radiodermitis (3.6%). Response rates and toxicity were not significantly different among those patients with and without induction chemotherapy, but survival was higher in patients receiving induction.CONCLUSIONS:
Gemcitabine alternating with cisplatin concurrent with radiotherapy is an active and safe treatment that deserves further study.
Texto completo:
1
Colección:
01-internacional
Banco de datos:
MEDLINE
Asunto principal:
Fármacos Sensibilizantes a Radiaciones
/
Carcinoma de Células Escamosas
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Cisplatino
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Desoxicitidina
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Quimioradioterapia
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Neoplasias de Cabeza y Cuello
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Antimetabolitos Antineoplásicos
/
Antineoplásicos
Tipo de estudio:
Etiology_studies
/
Observational_studies
/
Prognostic_studies
/
Risk_factors_studies
Límite:
Adult
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Female
/
Humans
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Male
/
Middle aged
Idioma:
En
Revista:
Oral Oncol
Asunto de la revista:
NEOPLASIAS
Año:
2013
Tipo del documento:
Article
País de afiliación:
México