Subcategory:
Category:
Head and Neck Cancer
Meeting:
Session Type and Session Title:
General Poster Session, Head and Neck Cancer
Abstract Number:
5566
Citation:
J Clin Oncol 28:15s, 2010 (suppl; abstr 5566)
Author(s):
- A. AL Saleh, R. Safwat, A. Bedair, A. AL Basmy; Kuwait Cancer Control Center, Kuwait City, Kuwait
Abstract:
Background: Extensive clinical research aimed at improving locoregional tumor control as well as functional outcome of patients with locally advanced head and neck cancer, using altered radiation fractionation schemes and combination with chemotherapy. We investigated the feasibility of combining hyperfractionated radiotherapy with concomitant chemotherapy, and to assessed its toxicity, in those patients. Progression-free survival, and overall survival, were set as secondary end points. Methods: Between November 2003 and November of 2007, 48 patients with stage III and IV HNC who met the eligibility criteria were enrolled in the study. All the patients had unresectable disease. Hyperfractionated Radiation consisted of 120 cGy twice daily, 6 hours apart, for a total of 69.6 Gys in 58 fractions over 6 weeks. Three cycles of concurrent chemotherapy (cisplatin and 5-fluorouracil) were delivered during weeks 1, 4, and 6 of irradiation. Results: The treatment was delivered in a median overall period of 54 days, with a recorded median delay of 7 days. Grade 4 skin toxicity was experienced by 4.1% of patients only. Therapy was well tolerated (grade 3 mucositis in 21%, grade 4 in 26%, grade 3 leukopenia in 10%). Weight loss more than 10 kg was reported in 10 (16.7%) of the cases. The most common late toxicity was mild to moderate xerostomia which was encountered in 34 (70.8%) cases and improved thereafter. Hypothyroidism was encountered in 7 (14.6%) of the cases. Complete response (CR) was observed in 40 (83.3%) of patients. Partial response (PR) was achieved in the remaining 8 (16.7%) patients. Disease relapse occurred in 9 (18.8%) patients after complete responce. 3 patients relapsed locally, 5 patients developed distant metastasis, and one patient developed both local and distant metastasis. 2 patients (4.1%) died of treatment complications, 8 patients (16.7%) died with progressive locoregional, and metastatic disease. The 2- year disease free survival was 77%. Conclusions: Hyperfractionated radiotherapy and concurrent chemotherapy is tolerable. Results regarding LC and OS are encouraging as compared to conventional radiotherapy and concurrent chemotherapy.
