Original Articles

Clinical and Translational Oncology

, Volume 7, Issue 2, pp 60-65

Concomitant boost radiation and concurrent cisplatin for advanced head and neck carcinomas. Preliminary results of a phase II, single-institutional trial

  • Fernando Arias de la VegaAffiliated withService of Radiation Oncology. Head and Neck Division, Hospital de Navarra Email author 
  • , Miguel Angel Domínguez DomínguezAffiliated withService of Radiation Oncology. Head and Neck Division, Hospital de Navarra
  • , Ana Manterola BurgaletaAffiliated withService of Radiation Oncology. Head and Neck Division, Hospital de Navarra
  • , Ruth Vera GarcíaAffiliated withService of Medical Oncology, Hospital de Navarra
  • , Maria Eugenia Echeverría ZabalzaAffiliated withService of Otolaryngology, Hospital Virgen del Camino
  • , Eugenio Oria MundinAffiliated withService of Nutrition, Hospital de Navarra
  • , Enrique Martínez LópezAffiliated withService of Radiation Oncology. Head and Neck Division, Hospital de Navarra
  • , Pilar Romero RojanoAffiliated withService of Radiation Oncology. Head and Neck Division, Hospital de Navarra
  • , Elena Villafranca ItureAffiliated withService of Radiation Oncology. Head and Neck Division, Hospital de Navarra

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Abstract

Introduction

This study aims to asses the effectiveness and toxicity of boost radiotherapy concomitant and concurrent cisplatin for patients with locally-advanced head and neck cancer (LAHNC).

Material and methods

There were 30 patients included in a prospective, phase II single-institution trial and of whom, 29 were at AJCC stage IV and 1 at stage III. Treatment consisted of radiotherapy-acceleration fractionation with concomitant boost, 72 Gy, and 2 cycles of concomitant cisplatin (20 mg/m2/day continuous infusion; days 1–5 and 29–33). Amifostine, (i.v. 200 mg/m2) was administered to 26 prior to the first fraction of radiotherapy. Endpoints of the study were quality-of-life (QL), overall survival, and local control of disease.

Results

Complete response (CR) was achievedin 23 patients (77%), 2 patients had partial response (PR) (7%), 4 had no response (13%), and 1 was not evaluated for response. The 2-year overall survival and loco-regional control were 60% and 56%, respectively. Main toxicity was grade 3 or 4 mucositis in 93% of the patients. QL scores (questionnaire QLQ-C30; version 3.0) and the HN cancer module QLQ-HN35) showed a worsening in areas related to the treatment e.g. dry mouth, problems stretching the mouth, and sticky saliva.

Conclusions

this combination modality is active, but toxic, in the treatment for LAHNC. Concomitant boost radiotherapy is probably, not the best radiotherapy schema for combining with chemotherapy in LAHNC.

Key words

chemo-radiotherapy head and neck cancer