Concurrent radiation therapy and chemotherapy for locally unresectable squamous cell head and neck cancer: An Eastern Cooperative Oncology Group pilot study

D. J. Adelstein, L. A. Kalish, G. L. Adams, H. Wagner, M. M. Oken, S. C. Remick, E. G. Mansour, R. E. Haselow

Research output: Contribution to journalArticlepeer-review

68 Scopus citations

Abstract

Purpose: The feasibility and success of an intensive chemoradiotherapeutic protocol for patients with locally advanced, unresectable squamous cell head and neck cancer was tested in this limited-institution. Eastern Cooperative Oncology Group phase II pilot study. Materials and Methods: Between December 1987 and September 1989, 57 patients were entered onto this trial. The treatment protocol consisted of three courses of a 4-day continuous fluorouracil infusion, a single cisplatin bolus injection, and concurrent splitcourse radiotherapy. After 30 Gy of radiation and two chemotherapy courses, patients were evaluated for response and for the possibility of surgical resection. Results: Fifty-five of 57 registered patients are assessable for toxicity and 52 are assessable for response and survival. Toxicity was significant, but tolerable, al-though there were three toxic deaths. A complete response to this treatment was ultimately achieved by 77% of patients. Twenty-four patients remain relapse-free. The projected Kaplan-Meier 4-year relapse-free survival rate is 45% and the overall survival rate is 49%. Median relapse-free and overall survival durations are 26 and 37 months, respectively. Of the 28 treatment failures, 79% were locoregional. Fourteen patients underwent surgery. Six remain relapse-free. Conclusion: This aggressive concurrent chemoradiotherapy protocol appears feasible within a cooperative group. Treatment results are promising and appear durable. A randomized phase III clinical trial is currently underway.

Original languageEnglish (US)
Pages (from-to)2136-2142
Number of pages7
JournalJournal of Clinical Oncology
Volume11
Issue number11
StatePublished - 1993

All Science Journal Classification (ASJC) codes

  • Oncology
  • Cancer Research

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