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Gemcitabine-based induction chemotherapy and concurrent with radiation in advanced head and neck cancer

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Abstract

To evaluate the efficacy and toxicity of gemcitabine-based induction chemotherapy followed by concurrent gemcitabine and radiotherapy in advanced squamous cell carcinoma of head and neck. A total of 28 patients with locally advanced squamous cell carcinoma of the head and neck were enrolled. All patients were treated with 2 cycles of induction gemcitabine 1 gm/m2 on days1 and 8 plus cisplatin 75 mg/m2no day 1 of a 3-week cycles followed by conventionally fractionated radiotherapy to 70 Gy in 35 fractions concurrent with weekly gemcitabine 100 mg/m2 within 2 h before radiotherapy. Median age was 56.5 years (range, 30–68). Four patients (14.3 %) achieved complete response (CR) and 19 patients (67.9 %) had partial response (PR) after induction chemotherapy. After concurrent chemo-radiotherapy, we reported 17 (60.7 %) CR and 8 (28.6 %) PR. Median loco-regional recurrence-free survival, progression-free survival, and overall survival were 17, 12.5, and 21 months, respectively. Performance status, T stage, AJCC stage, and response to chemo-radiation were found to have significant impact on survival. Acute grade 3 toxicity of concurrent chemo-radiation included 35.7 % dysphagia, 25 % stomatitis, and 10.7 % neutropenia, whereas late grade 3 toxicity included xerostomia in 7.1 % and stomatitis in 3.6 % of patients. Gemcitabine-based induction and concurrent chemo-radiotherapy is effective treatment for locally advanced squamous cell carcinoma of head and neck with acceptable and manageable toxicity. Optimizing dose and schedule of gemcitabine-based chemo-radiation is still needed.

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Acknowledgments

The authors declare hereby that the study did not receive any form of financial support.

Conflict of interest

No conflict of interest emerged during the implementation of this work. The paper had not been presented at any congress before.

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Authors and Affiliations

  1. Clinical Oncology and Nuclear Medicine Department, Faculty of Medicine, Mansoura University, Mansoura, Egypt

    Doaa Ali Sharaf El Deen & Eman Abd Elkareem Toson

  2. ORL Head and Neck Surgery, Faculty of Medicine, Mansoura University, Mansoura, Egypt

    Shawky Mahmoud El Morsy

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  1. Doaa Ali Sharaf El Deen
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  2. Eman Abd Elkareem Toson
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Correspondence to Eman Abd Elkareem Toson.

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El Deen, D.A.S., Toson, E.A.E. & El Morsy, S.M. Gemcitabine-based induction chemotherapy and concurrent with radiation in advanced head and neck cancer. Med Oncol 29, 3367–3373 (2012). https://doi.org/10.1007/s12032-012-0269-x

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