Skip to main content

Concurrent Chemoradiotherapy

Impact on Survival and Organ Preservation

  • Chapter
Squamous Cell Head and Neck Cancer

Part of the book series: Current Clinical Oncology ((CCO))

  • 864 Accesses

Abstract

Initial efforts to integrate systemic chemotherapy into the definitive management of squamous cell head and neck cancer focused on sequential treatment schedules. Given the impressive response rates seen with multiagent chemotherapy in previously untreated patients, considerable effort went into the study of induction or neoadjuvant treatment schedules (1). Numerous randomized trials have now been completed. Although induction chemotherapy has been generally well tolerated, and appears to decrease the likelihood of distant metastatic disease, no consistent survival benefit has been demonstrated from this treatment approach alone (2).

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 129.00
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
Hardcover Book
USD 169.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

Preview

Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.

References

  1. Adelstein DJ, Tan EH, Lavertu P. Treatment of head and neck cancer: the role of chemotherapy. Crit Rev Oncol Hematol 1996;24:97–116

    Article  PubMed  CAS  Google Scholar 

  2. Adelstein DJ. Induction chemotherapy in head and neck cancer. Hematol Oncol Clin N Am 1999;13:689–698.

    Article  CAS  Google Scholar 

  3. Kinsella TJ. An approach to the radiosensitization of human tumors. Cancer J Sci Am 1996;2:184–193.

    PubMed  CAS  Google Scholar 

  4. Vokes EE, Weichselbaum RR. Concomitant chemoradiotherapy: Rationale and clinical experience in patients with solid tumors. J Clin Oncol 1990;8:911–934.

    PubMed  CAS  Google Scholar 

  5. Lo TCM, Wiley AL, Ansfield FJ, et al. Combined radiation therapy and 5-fluorouracil for advanced squamous cell carcinoma of the oral cavity and oropharynx: a randomized study. Am J Roentgenol 1976;126:229–235.

    CAS  Google Scholar 

  6. Sanchiz F, Millá A, Torner J, et al. Single fraction per day versus two fractions per day versus radiochemotherapy in the treatment of head and neck cancer. Int J Radiat Oncol Biol Phys 1990;19:1347–1350.

    PubMed  CAS  Google Scholar 

  7. Browman GP, Cripps C, Hodson DI, et al. Placebo-controlled randomized trial of infusional fluorouracil during standard radiotherapy in locally advanced head and neck cancer. J Clin Oncol 1994;12:2648–2653.

    PubMed  CAS  Google Scholar 

  8. Shanta V, Krishnamurthi S. Combined bleomycin and radiotherapy in oral cancer. Clin Radiol 1980;31:617–620.

    Article  PubMed  CAS  Google Scholar 

  9. Vermund H, Kaalhus O, Winther F, et al. Bleomycin and radiation therapy in squamous cell carcinoma of the upper aero-digestive tract: a phase III clinical trial. Int J Radiat Oncol Biol Phys 1985;11:1877–1886.

    PubMed  CAS  Google Scholar 

  10. Fu KK, Phillips TL, Silverberg IJ, et al. Combined radiotherapy and chemotherapy with bleomycin and methotrexate for advanced inoperable head and neck cancer: update of a Northern California Oncology Group randomized trial. J Clin Oncol 1987;5:1410–1418.

    PubMed  CAS  Google Scholar 

  11. Eschwege F, Sancho-Garnier H, Gerard JP, et al. Ten-year results of randomized trial comparing radiotherapy and concomitant bleomycin to radiotherapy alone in epidermoid carcinomas of the oropharynx: experience of the European Organization for Research and Treatment of Cancer. NCI Monogr 1988;6:275–278.

    PubMed  Google Scholar 

  12. Haselow RE, Warshaw MG, Oken MM, et al. Radiation alone versus radiation with weekly low dose cis-platinum in unresectable cancer of the head and neck cancer. In: Fee WE, Jr, Goepfert H, Johns ME, et al., eds. Head and Neck Cancer, vol II. Philadelphia: JB Lippincott, 1990: pp. 279–281.

    Google Scholar 

  13. Jeremic B, Shibamoto Y, Stanisavljevic B, et al. Radiation therapy alone or with concurrent low-dose daily either cisplatin or carboplatin in locally advanced unresectable squamous cell carcinoma of the head and neck: a prospective randomized trial. Radiother and Oncol 1997;43:29–37.

    Article  CAS  Google Scholar 

  14. Jeremic B, Shibamoto Y, Milicic B, et al. Hyperfractionated radiation therapy with or without concurrent low-dose daily cisplatin in locally advanced squamous cell carcinoma of the head and neck: a prospective randomized trial. J Clin Oncol 2000;18:1458–1464.

    PubMed  CAS  Google Scholar 

  15. Adelstein DJ, Li Y, Adams GL, et al. An Intergroup phase III comparison of standard radiation therapy and two schedules of concurrent chemoradiotherapy in patients with unresectable squamous cell head and neck cancer. J Clin Oncol 2003;21:92–98.

    Article  PubMed  Google Scholar 

  16. Haselow RE, Adams GS, Oken MM, et al. Cis-platinum (DDP) with radiation therapy (RT) for locally advanced unresectable head and neck cancer. Proc ASCO 1983;2:160 (Abstr).

    Google Scholar 

  17. Marcial VA, Pajak TF, Mohiuddin M, et al. Concomitant cisplatin chemotherapy and radiotherapy in advanced mucosal squamous cell carcinoma of the head and neck. Cancer 1990;66:1861–1868.

    Article  PubMed  CAS  Google Scholar 

  18. Adelstein DJ. Recent randomized trials of chemoradiation in the management of locally advanced head and neck cancer. Curr Opin Oncol 1998;10:213–218.

    Article  PubMed  CAS  Google Scholar 

  19. Weissler MC, Melin S, Sailer SL, et al. Simultaneous chemoradiation in the treatment of advanced head and neck cancer. Arch Otolaryngol Head Neck Surg 1992;118:806–810.

    PubMed  CAS  Google Scholar 

  20. Adelstein DJ, Saxton JP, Lavertu P et al. A phase III randomized trial comparing concurrent chemotherapy and radiotherapy with radiotherapy alone in resectable stage III and IV squamous cell head cancer: Preliminary results. Head Neck 1997;19:567–575.

    Article  PubMed  CAS  Google Scholar 

  21. Wendt TG, Grabenbauer GG, Rödel CM, et al. Simultaneous radiochemotherapy versus radiotherapy alone in advanced head and neck cancer: a randomized multicenter study. J Clin Oncol 1998;16:1318–1324.

    PubMed  CAS  Google Scholar 

  22. Brizel DM, Albers ME, Fisher SR, et al. Hyperfractionated irradiation with or without concurrent chemotherapy for locally advanced head and neck cancer. N Engl J Med 1998;338:1798–1804.

    Article  PubMed  CAS  Google Scholar 

  23. Calais G, Alfonsi M, Bardet E, et al. Randomized trial of radiation therapy versus concomitant chemotherapy and radiation therapy for advanced-stage oropharynx carcinoma. J Natl Cancer Inst 1999;91:2081–2086.

    Article  PubMed  CAS  Google Scholar 

  24. Staar S, Rudat V, Stuetzer H, et al. Intensified hyperfractionated accelerated radiotherapy limits the additional benefit of simultaneous chemotherapy—results of a multicentric randomized German trial in advanced head and neck cancer. Int J Radiat Oncol Biol Phys 2001;50:1161–1171.

    Article  PubMed  CAS  Google Scholar 

  25. Denis F, Garaud P, Bardet E, et al. Final results of the 94-01 French Head and Neck Oncology and Radiotherapy Group randomized trial comparing radiotherapy alone with concomitant radiochemotherapy in advanced stage oropharynx carcinoma. J Clin Oncol 2004;22:69–76.

    Article  PubMed  Google Scholar 

  26. Taylor SG, Murthy AK, Vannetzel J-M, et al. Randomized comparison of neoadjuvant cisplatin and fluorouracil infusion followed by radiation versus concomitant treatment in advanced head and neck cancer. J Clin Oncol 1994;12:385–395.

    PubMed  Google Scholar 

  27. Adelstein DJ, Sharan VM, Earle AS, et al. Long-term follow-up of a prospective randomized trial comparing simultaneous and sequential chemoradiotherapy for squamous cell head and neck cancer. In: Salmon SE, ed. Adjuvant Therapy of Cancer VII. Philadelphia: JB Lippinott, 1993: pp. 82–91.

    Google Scholar 

  28. Pinnarò P, Cercato MC, Giannarelli D, et al. A randomized phase II study comparing sequential versus simultaneous chemo-radiotherapy in patients with unresectable locally advanced squamous cell cancer of the head and neck. Ann Oncol 1994;5:513–519.

    PubMed  Google Scholar 

  29. Pignon JP, Bourhis J, Domenge C, et al. Chemotherapy added to locoregional treatment for head and neck squamous-cell carcinoma: three meta-analyses of updated individual data. Lancet 2000;355:949–955.

    PubMed  CAS  Google Scholar 

  30. Robbins KT, Kumar P, Regine WF, et al. Efficacy of targeted supradose cisplatin and concomitant radiation therapy for advanced head and neck cancer: the Memphis experience. Int J Radiat Oncol Biol Phys 1997;38:263–271.

    Article  PubMed  CAS  Google Scholar 

  31. Vokes EE, Kies MS, Haraf DJ, et al. Concomitant chemoradiotherapy as primary therapy for locoregionally advanced head and neck cancer. J Clin Oncol 2000;18:1652–1661.

    PubMed  CAS  Google Scholar 

  32. Adelstein DJ, Saxton JP, Lavertu P, et al. Maximizing local control and organ preservation in stage IV squamous cell head and neck cancer with hyperfractionated radiation and concurrent chemotherapy. J Clin Oncol 2002;20:1405–1410.

    Article  PubMed  Google Scholar 

  33. Fu KK, Pajak TF, Trotti A, et al. A Radiation Therapy Oncology Group (RTOG) phase III randomized study to compare hyperfractionation and two variants of accelerated fractionation to standard fractionation radiotherapy for head and neck squamous cell carcinomas: First report of RTOG 9003. Int J Radiat Oncol Biol Phys 2000;48:7–16.

    Article  PubMed  CAS  Google Scholar 

  34. Mekhail TM, Adelstein DJ, Rybicki LA, et al. Enteral nutrition during the treatment of head and neck carcinoma. Cancer 2001;91:1785–1790.

    Article  PubMed  CAS  Google Scholar 

  35. Trotti A, Bentzen SM. The need for adverse effects reporting standards in oncology clinical trials. J Clin Oncol 2004;22:19–22.

    Article  PubMed  Google Scholar 

  36. Adelstein DJ. Oropharyngeal cancer: the role of the medical oncologist in organ-function conservation. In: Perry MC, ed. American Society of Clinical Oncology Education Book. Alexandria, VA: American Society of Clinical Oncology 1999: pp. 544–550.

    Google Scholar 

  37. Wolf GT, Hong WK, Fisher SG, et al. Induction chemotherapy plus radiation compared with surgery plus radiation in patients with advanced laryngeal cancer. N Engl J Med 1991;324:1685–1690.

    Article  Google Scholar 

  38. Lefebvre JL, Chevalier D, Luboinski B, et al. Larynx preservation in pyriform sinus cancer: preliminary results of a European Organization for Research and Treatment of Cancer phase III trial. J Natl Cancer Inst 1996;88:890–899.

    Article  PubMed  CAS  Google Scholar 

  39. Forastiere AA, Goepfert H, Maor M, et al. Concurrent chemotherapy and radiotherapy for organ preservation in advanced laryngeal cancer. N Engl J Med 2003;349:2091–2098.

    Article  PubMed  CAS  Google Scholar 

  40. Weber RS, Berkey BA, Forastiere A, et al. Outcome of salvage total laryngectomy following organ preservation therapy. The Radiation Therapy Oncology Group trial 91-11. Arch Otolaryngol Head Neck Surg 2003;129:44–49.

    Article  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Editor information

Editors and Affiliations

Rights and permissions

Reprints and permissions

Copyright information

© 2005 Humana Press Inc., Totowa, NJ

About this chapter

Cite this chapter

Adelstein, D.J. (2005). Concurrent Chemoradiotherapy. In: Adelstein, D.J. (eds) Squamous Cell Head and Neck Cancer. Current Clinical Oncology. Humana Press. https://doi.org/10.1007/978-1-59259-938-7_13

Download citation

  • DOI: https://doi.org/10.1007/978-1-59259-938-7_13

  • Publisher Name: Humana Press

  • Print ISBN: 978-1-58829-473-9

  • Online ISBN: 978-1-59259-938-7

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics