Long-term outcomes with concurrent carboplatin, paclitaxel and radiation therapy for locally advanced, inoperable head and neck cancer

S. S. Agarwala, E. Cano, D. E. Heron, J. Johnson, E. Myers, V. Sandulache, S. Bahri, R. Ferris, Y. Wang, A. Argiris

Research output: Contribution to journalArticle

33 Scopus citations

Abstract

Background: Our goal was to evaluate long-term efficacy outcomes of patients with squamous cell carcinoma of the head and neck (SCCHN) treated with carboplatin, paclitaxel (Taxol) and radiotherapy. Patientsand methods: We conducted a phase II trial in inoperable patients with locally advanced SCCHN. Carboplatin 100 mg/m2 and paclitaxel 40 mg/m2 were administered i.v. once a week during external beam radiation therapy (180 cGy per fraction) for 6-7 weeks. Interstitial brachytherapy was used as a boost in selected patients with primary malignancies of the oral cavity and the oropharynx. Results: Fifty-five patients were enrolled. Fifty-two patients (95%) had stage IV and 51 (93%) had technically unresectable disease; 62% had an oropharyngeal primary site. Twenty-one patients underwent brachytherapy boost. Grade 3 or 4 mucositis occurred in 30% of patients. One death occurred during treatment that was related to complications of gastrostomy tube placement. Forty of 50 assessable patients (80%) had an objective response, with a complete response rate of 52%. With a median follow-up of 69 months for surviving patients, the 5-year progression-free survival was 36% and the 5-year overall survival was 35%. Two of the 18 long-term survivors of >50 months were gastrostomy tube feeding dependent. Patients undergoing brachytherapy boost (n = 21) had similar outcomes compared with the rest of the patients. In multivariate analysis, baseline hemoglobin levels and N stage were predictive of survival. Conclusion: Treatment with concurrent carboplatin, paclitaxel and radiation is safe and offers curative potential for poor prognosis patients with locally advanced SCCHN.

Original languageEnglish (US)
Pages (from-to)1224-1229
Number of pages6
JournalAnnals of Oncology
Volume18
Issue number7
DOIs
StatePublished - Jul 1 2007
Externally publishedYes

Keywords

  • Brachytherapy
  • Carboplatin
  • Head and neck cancer
  • Paclitaxel
  • Radiation

ASJC Scopus subject areas

  • Hematology
  • Oncology

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    Agarwala, S. S., Cano, E., Heron, D. E., Johnson, J., Myers, E., Sandulache, V., Bahri, S., Ferris, R., Wang, Y., & Argiris, A. (2007). Long-term outcomes with concurrent carboplatin, paclitaxel and radiation therapy for locally advanced, inoperable head and neck cancer. Annals of Oncology, 18(7), 1224-1229. https://doi.org/10.1093/annonc/mdm088