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Titolo:
Pilot study of organ preservation multimodality therapy for locally advanced resectable oropharyngeal carcinoma
Autore:
Machtay, M; Rosenthal, DI; Algazy, KM; Aviles, VM; Chalian, AA; Hershock, D; Neubauer, R; Greenberg, MJ; Mirza, N; Weinstein, GS; Weber, RS;
Indirizzi:
Hosp Univ Penn, Dept Radiat Oncol, Philadelphia, PA 19104 USA Hosp Univ Penn Philadelphia PA USA 19104 ncol, Philadelphia, PA 19104 USA Hosp Univ Penn, Dept Med, Div Med Oncol, Philadelphia, PA 19104 USA Hosp Univ Penn Philadelphia PA USA 19104 ncol, Philadelphia, PA 19104 USA Hosp Univ Penn, Dept Otorhinolaryngol Head & Neck Surg, Philadelphia, PA 19104 USA Hosp Univ Penn Philadelphia PA USA 19104 Surg, Philadelphia, PA 19104 USA
Titolo Testata:
AMERICAN JOURNAL OF CLINICAL ONCOLOGY-CANCER CLINICAL TRIALS
fascicolo: 5, volume: 23, anno: 2000,
pagine: 509 - 515
SICI:
0277-3732(200010)23:5<509:PSOOPM>2.0.ZU;2-A
Fonte:
ISI
Lingua:
ENG
Soggetto:
SQUAMOUS-CELL CARCINOMA; NECK-CANCER PATIENTS; ADVANCED HEAD; CONCOMITANT CHEMORADIOTHERAPY; INDUCTION CHEMOTHERAPY; RADIATION-THERAPY; ONCOLOGY-GROUP; FINAL REPORT; PHASE-II; RADIOTHERAPY;
Keywords:
pilot study; organ preservation; multimodality therapy; oropharyngeal carcinoma;
Tipo documento:
Article
Natura:
Periodico
Settore Disciplinare:
Clinical Medicine
Citazioni:
30
Recensione:
Indirizzi per estratti:
Indirizzo: Machtay, M Hosp Univ Penn, Dept Radiat Oncol, 2 Donner Bldg,3400 Spruce St, Philadelphia, PA 19104 USA Hosp Univ Penn 2 Donner Bldg,3400 Spruce St Philadelphia PA USA 19104
Citazione:
M. Machtay et al., "Pilot study of organ preservation multimodality therapy for locally advanced resectable oropharyngeal carcinoma", AM J CL ONC, 23(5), 2000, pp. 509-515

Abstract

The purpose of this study was to determine the early efficacy and toxicityof a new multimodality organ-preservation regimen for locally advanced, resectable oropharyngeal squamous cell carcinoma (SCC). Patients with T3-4N0-3M9 or T2N2-3M0 oropharyngeal SCC were eligible for this Phase II study. Patients needed the physiologic reserve for surgery and technically resectable tumors. Induction carboplatin (area under the curve = 6) and paclitaxel (200 mg/m(2)) x 2 cycles (921 days) were given. Objective responders received definitive radiotherapy (XRT), 70 Gy/7 weeks with concurrent weekly paclitaxel. Initially, the dose of paclitaxel was 50 mg/m(2)/week; because of mucosal toxicity it was reduced to 30 mg/m(2)/week. Patients with N2-3 disease received post-XRT neck dissection and 2 more cycles of "adjuvant" chemotherapy. In the first 22 patients, the neutropenic fever rate was 27%. Although there has been no grade IV-V toxicity from induction therapy, grade II-III toxicity resulted in an unacceptable delay in starting XRT in 14% of patients. The response rate to induction chemotherapy was 91%. Grade III mucositis occurred in all patients during concurrent chemoradiotherapy. One patient died of pneumonia during concurrent chemoradiotherapy after receiving 26 Gy and 3 doses of paclitaxel 50 mg/m(2). No dose-limiting toxicity occurred in 15 patients treated with concurrent paclitaxel 30 mg/m(2)/week. Actuarial overall survival at 18 months is 82%; local-regional control is 86%. To date, distant metastases have not developed in any patients. This regimenhas intense but acceptable acute toxicity. The maximum tolerated dosage ofweekly paclitaxel during standard continuous-course XRT is confirmed to be30 mg/m(2)/week. The treatment efficacy of this regimen (response rate andshort-term local-regional and distant control) is encouraging. Accrual continues to obtain long-term toxicity, efficacy, and quality-of-life data.

ASDD Area Sistemi Dipartimentali e Documentali, Università di Bologna, Catalogo delle riviste ed altri periodici
Documento generato il 29/11/20 alle ore 00:51:22