This Article Full Text Full Text (PDF) Purchase Article View Shopping Cart Alert me when this article is cited Alert me if a correction is posted Services Email this article to a colleague Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Save to my personal folders Download to citation manager Rights & Permissions Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Sunwoo, J. B. Articles by Van Waes, C. Search for Related Content PubMed PubMed Citation Articles by Sunwoo, J. B. Articles by Van Waes, C. Social Bookmarking                            What's this?

Concurrent Paclitaxel and Radiation in the Treatment of Locally Advanced Head and Neck Cancer

From the Head and Neck Surgery Branch, National Institute of Deafness and Other Communication Disorders; Speech and Language Pathology Section, Rehabilitation Medicine Department, Clinical Center; and Branches of Radiation Oncology, Radiation Biology, Biometric Research, and Medicine, National Cancer Institute, National Institutes of Health, Bethesda, MD.

Address reprint requests to Laurie L. Herscher, MD, Radiation Oncology Branch, National Cancer Institute, National Institutes of Health, 9000 Rockville Pike, Bldg 10, Rm B3B69, Bethesda, MD 20892; email: herscher{at}mail.nih.gov

PURPOSE: To determine the feasibility of an organ preservation regimen consisting of infusional paclitaxel administered concurrently with radiotherapy to patients with locally advanced head and neck squamous cell carcinoma (HNSCC).

PATIENTS AND METHODS: Thirty-three previously untreated patients with stage III or IV tumors were enrolled onto the study. Paclitaxel was administered as a 120-hour continuous infusion every 3 weeks during the course of radiation therapy. Sixteen patients received a paclitaxel dose of 105 mg/m², and 17 patients received 120 mg/m². Radiation was delivered in a standard format at 1.8 Gy/d to a total dose of 70.2 to 72 Gy.

RESULTS: Three months after therapy, a 76% complete response (CR) at the primary site and a 70% overall CR was achieved. At 36 months, locoregional control was 55.7%, overall survival was 57.8%, and disease-free survival was 51.1%. The median survival duration for all 33 patients was greater than 50 months at the time of this report. Local toxicities including mucositis, dysphagia, and skin reactions were severe but tolerable. All patients retained functional speech, and all but four patients were swallowing food 3 months after treatment. Steady-state plasma concentrations for paclitaxel were not achieved during a 120-hour infusion, suggesting a nonlinear process. Tumor volume quantified by pretreatment computerized tomography imaging was associated with likelihood of response and survival.

CONCLUSION: Paclitaxel administered as a 120-hour continuous infusion in combination with radiotherapy is a feasible and promising treatment for patients with advanced HNSCC.

CiteULike    Complore    Connotea    Del.icio.us    Digg    Facebook    Reddit    Technorati    Twitter    What's this?

This article has been cited by other articles:

				F. G. Pernas, C. T. Allen, M. E. Winters, B. Yan, J. Friedman, B. Dabir, K. Saigal, G. S. Mundinger, X. Xu, J. C. Morris, et al. Proteomic Signatures of Epidermal Growth Factor Receptor and Survival Signal Pathways Correspond to Gefitinib Sensitivity in Head and Neck Cancer Clin. Cancer Res., April 1, 2009; 15(7): 2361 - 2372. [Abstract] [Full Text] [PDF]

				T. Yoshida, R. Tokashiki, H. Itoh, K. Nakamura, H. Hiramatsu, K. Tsukahara, S. Shimizu, D. Takada, I. Okamoto, K. Abe, et al. A phase I II Study of Bi-weekly Docetaxel Combined with Radiation Therapy for Patients with Cancer of the Larynx/hypopharynx Jpn. J. Clin. Oncol., September 1, 2007; 37(9): 641 - 646. [Abstract] [Full Text] [PDF]

				J. E. Morgan, R. L. Breau, J. Y. Suen, and E. Y. Hanna Surgical Wound Complications After Intensive Chemoradiotherapy for Advanced Squamous Cell Carcinoma of the Head and Neck Arch Otolaryngol Head Neck Surg, January 1, 2007; 133(1): 10 - 14. [Abstract] [Full Text] [PDF]

				M. Sui, J. M. Dziadyk, X. Zhu, and W. Fan Cell Cycle-Dependent Antagonistic Interactions between Paclitaxel and {gamma}-Radiation in Combination Therapy Clin. Cancer Res., July 15, 2004; 10(14): 4848 - 4857. [Abstract] [Full Text] [PDF]

				F. R. Rosen, D. J. Haraf, M. S. Kies, K. Stenson, L. Portugal, M. A. List, B. E. Brockstein, B. B. Mittal, A. W. Rademaker, M. E. Witt, et al. Multicenter Randomized Phase II Study of Paclitaxel (1-Hour Infusion), Fluorouracil, Hydroxyurea, and Concomitant Twice Daily Radiation with or without Erythropoietin for Advanced Head and Neck Cancer Clin. Cancer Res., May 1, 2003; 9(5): 1689 - 1697. [Abstract] [Full Text] [PDF]

				P. W. T. Pisters, R. A. Wolff, N. A. Janjan, K. R. Cleary, C. Charnsangavej, C. N. Crane, R. Lenzi, J. Nicolas Vauthey, J. E. Lee, J. L. Abbruzzese, et al. Preoperative Paclitaxel and Concurrent Rapid-Fractionation Radiation for Resectable Pancreatic Adenocarcinoma: Toxicities, Histologic Response Rates, and Event-Free Outcome J. Clin. Oncol., May 15, 2002; 20(10): 2537 - 2544. [Abstract] [Full Text] [PDF]