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La radiochimiothérapie dans les carcinomes épidermoïdes des voies aérodigestives supérieures

Chemoradiotherapy in squamous cell carcinoma of head and neck cancers

  • Synthèse / Review Article
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Oncologie

Abstract

Concomitant chemoradiation (alone or adjuvant) provides a significant survival benefit of about 8% in head and neck squamous cell carcinomas. Platin-based (Al-Sarraf’s cisplatin regimen or fluoro-uracile-carboplatin) chemoradiation is the standard treatment in locally advanced head and neck squamous cell carcinomas for patients ≤ 70-years-old. Anti-EGFR and altered fractionated radiotherapy regimens also provide significant survival benefit but are not indicated in the postoperative setting. They can be suggested in cases of contraindication to chemotherapy. The place of anti-EGFR after intensive induction regimens like the TPF scheme and as first line treatment is still being investigated.

Résumé

La radiochimiothérapie concomitante (en exclusif ou adjuvant) comportant un platine apporte un bénéfice en survie de l’ordre de 8 % à cinq ans. L’association (avec cisplatine du schéma Al-Sarraf, voire fluoro-uracile-carboplatine) est le traitement standard des carcinomes épidermoïdes localement avancés des voies aérodigestives supérieures (VADS) pour les patients âgés de 70 ans ou moins. Les anti-EGFR et les irradiations à fractionnement modifié apportent également un bénéfice en survie globale mais ne sont pas indiqués en situation postopératoire. Ils peuvent être proposés en cas de contre-indication à la chimiothérapie. La place des anti-REGF après des schémas d’induction type TPF et en première intention en concomitant est encore en évaluation.

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Références

  1. Adelstein DJ, Lavertu P, Saxton JP, et al. (2000) Mature results of a phase III randomized trial comparing concurrent chemoradiotherapy with radiation therapy alone in patients with stage III and IV squamous cell carcinoma of the head and neck. Cancer 88: 876–883

    Article  PubMed  CAS  Google Scholar 

  2. Al-Sarraf M, LeBlanc M, Giri PG, et al. (1998) Chemoradiotherapy versus radiotherapy in patients with advanced nasopharyngeal cancer: phase III randomized Intergroup study 0099. J Clin Oncol 16: 1310–1317

    PubMed  CAS  Google Scholar 

  3. Bartelink H, Kallman RF, Rapacchietta D, et al. (1986) Therapeutic enhancement in mice by clinically relevant dose and Tab fractionation schedules of cis-diamminedi-chloroplatinum (II) and irradiation. Radiother Oncol 6: 61–74

    Article  PubMed  CAS  Google Scholar 

  4. Bensadoun RJ, Benezery K, Dassonville O, et al. (2006) French multicenter phase III randomized study testing concurrent twice-a-day radiotherapy and cisplatin/5-fluoro-uracil chemotherapy (BiRCF) in unresectable pharyngeal carcinoma: results at two years (FNCLCC-GORTEC). Int J Radiat Oncol Biol Phys 64: 983–994

    PubMed  CAS  Google Scholar 

  5. Bernier J, Domenge C, Ozsahin M, et al. (2004) Postoperative irradiation with or without concomitant chemotherapy for locally advanced head and neck cancer. N Engl J Med 350: 1945–1952

    Article  PubMed  CAS  Google Scholar 

  6. Bourhis J, Overgaard J, Audry H, et al. (2006) Hyperfractionated or accelerated radiotherapy in head and neck cancer: a meta-analysis. Lancet 368: 843–854

    Article  PubMed  Google Scholar 

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

    Article  PubMed  CAS  Google Scholar 

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

    PubMed  CAS  Google Scholar 

  9. Budach V, Stuschke M, Budach W, et al. (2005) Hyperfractionated accelerated chemoradiation with concurrent fluorouracil-mitomycin is more effective than dose-escalated hyperfractionated accelerated radiation therapy alone in locally advanced head and neck cancer: final results of the radiotherapy cooperative clinical trials group of the German Cancer Society 95-06 Prospective Randomized Trial. J Clin Oncol 23: 1125–1135

    Article  PubMed  CAS  Google Scholar 

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

    Article  PubMed  CAS  Google Scholar 

  11. Cooper JS, Pajak TF, Forastiere AA, et al. (2004) Postoperative concurrent radiotherapy and chemotherapy for high-risk squamous-cell carcinoma of the head and neck. N Engl J Med 350: 1937–1944

    Article  PubMed  Google Scholar 

  12. Denis F, Garaud P, Bardet E, et al. (2004) 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 22: 69–76

    Article  PubMed  Google Scholar 

  13. Dobrowsky W, Naude J (2000) Continuous hyperfractionated accelerated radiotherapy with/without mitomycin C in head and neck cancers. Radiother Oncol 57: 119–124

    Article  PubMed  CAS  Google Scholar 

  14. Eschwege F, Sancho-Garnier H, Gerard JP, et al. (1988) 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 (6): 275–278

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

    Article  PubMed  CAS  Google Scholar 

  16. Fu KK, Phillips TL, Silverberg IJ, et al. (1987) 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 5: 1410–1418

    PubMed  CAS  Google Scholar 

  17. Gupta NK, Pointon RC, Wilkinson PM (1987) A randomised clinical trial to contrast radiotherapy with radiotherapy and methotrexate given synchronously in head and neck cancer. Clin Radiol 38: 575–581

    Article  PubMed  CAS  Google Scholar 

  18. Jeremic B, Shibamoto Y, Milicic B, et al. (2000) 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 18: 1458–1464

    PubMed  CAS  Google Scholar 

  19. Keane TJ, Cummings BJ, O’sullivan B, et al. (1993) A randomized trial of radiation therapy compared to split course radiation therapy combined with mitomycin C and 5-FU as initial treatment for advanced laryngeal and hypopharyngeal squamous carcinoma. Int J Radiat Oncol Biol Phys 25: 613–618

    PubMed  CAS  Google Scholar 

  20. Merlano M, Benasso M, Corvo R, et al. (1996) Five-year update of a randomized trial of alternating radiotherapy and chemotherapy compared with radiotherapy alone in treatment of unresectable squamous cell carcinoma of the head and neck. J Natl Cancer Inst 88: 583–589

    Article  PubMed  CAS  Google Scholar 

  21. Merlano M, Vitale V, Rosso R, et al. (1992) Treatment of advanced squamous-cell carcinoma of the head and neck with alternating chemotherapy and radiotherapy. N Engl J Med 327: 1115–1121

    PubMed  CAS  Google Scholar 

  22. Milano G, Santini J, Thyss A, et al. (1989) Optimization using the pharmacokinetics of the therapeutic index of CDDP-5-FU treatment over five continuous days. Bull Cancer 76: 905–908

    PubMed  CAS  Google Scholar 

  23. Pignon JP, Bourhis J, Domenge C, et al. (2000) Chemotherapy added to locoregional treatment for head and neck squamous-cell carcinoma: three meta-analyses of updated individual data. MACH-NC Collaborative Group. Metaanalysis of chemotherapy on head and neck cancer. Lancet 355: 949–955

    PubMed  CAS  Google Scholar 

  24. Pignon JP, Baujat B, Bourhis J (2005) Individual patient data meta-analyses in head and neck carcinoma: what have we learnt? Cancer Radiother 9: 31–36

    PubMed  Google Scholar 

  25. Pignon JP, Le Maitre A, Bourhis J (2007) Meta-analyses of chemotherapy in headand-neck cancer (MACH-NC): an update. Int J Radiat Oncol Biol Phys 69: S112–S114

    PubMed  Google Scholar 

  26. Taylor SG 4th, Murthy AK, Vannetzel JM, et al. (1994) Randomized comparison of neoadjuvant cisplatin and fluoro-uracil infusion followed by radiation versus concomitant treatment in advanced head and neck cancer. J Clin Oncol 12: 385–395

    PubMed  Google Scholar 

  27. Thariat J, Milas L, Ang KK (2007) Integrating radiotherapy with epidermal growth factor receptor antagonists and other molecular therapeutics for the treatment of head and neck cancer. Int J Radiat Oncol Biol Phys 15: 69(4): 974–984

    Google Scholar 

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Bénézery, K., Thariat, J. & Ortholan, C. La radiochimiothérapie dans les carcinomes épidermoïdes des voies aérodigestives supérieures. Oncologie 11, 140–146 (2009). https://doi.org/10.1007/s10269-008-1029-6

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  • DOI: https://doi.org/10.1007/s10269-008-1029-6

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