Abstract | PURPOSE: METHODS AND MATERIALS: The study included 215 patients with head-and-neck carcinoma distributed as follows: larynx, n = 100; hypopharynx, n = 50; oropharynx, n = 52; oral cavity, n = 13; Stage II, n = 8, Stage III, n = 71, and Stage IV, n = 136. Accelerated radiotherapy was given to a total dose of 64-68 Gy in 2-Gy fractions within 36-38 days. This was combined with carbogen breathing during irradiation and administration of nicotinamide (60-80 mg/kg) 1-1.5 h before irradiation. RESULTS: There was full compliance with carbogen breathing in 88% of the patients. A nicotinamide dose of 80 mg/kg produced severe nausea and vomiting, necessitating discontinuation of the drug, in 31% of the patients. Adjustment of the dose to 60 mg/kg and antiemesis prophylaxis reduced the discontinuation rate to 10%. Confluent mucositis was observed in 91% of the patients with a median duration of 6 weeks. Grade 4 late complications occurred in 5% of the patients. The actuarial 3-year local control rates were 80% for larynx, 69% for hypopharynx, 88% for oropharynx, and 37% for oral cavity tumors. For T3-4 tumors, the local control rates were 80% for larynx, 60% for hypopharynx, 87% for oropharynx, and 29% for oral cavity. Regional control rates were 100% for N0, 93% for N1, and 74% for N2 disease. CONCLUSION: ARCON yields high local and regional control rates in advanced head-and-neck carcinomas, and compliance is satisfactory and morbidity acceptable. The local control rate of 80% for T3 and T4 larynx carcinomas offers excellent possibilities for organ preservation.
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Authors | Johannes H A M Kaanders, Lucas A M Pop, Henri A M Marres, Ingolv Bruaset, Franciscus J A van den Hoogen, Matthijs A W Merkx, Albert J van der Kogel |
Journal | International journal of radiation oncology, biology, physics
(Int J Radiat Oncol Biol Phys)
Vol. 52
Issue 3
Pg. 769-78
(Mar 01 2002)
ISSN: 0360-3016 [Print] United States |
PMID | 11849800
(Publication Type: Clinical Trial, Clinical Trial, Phase II, Journal Article)
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Chemical References |
- Radiation-Sensitizing Agents
- Carbon Dioxide
- Niacinamide
- carbogen
- Oxygen
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Topics |
- Adult
- Aged
- Aged, 80 and over
- Carbon Dioxide
(administration & dosage)
- Dose Fractionation, Radiation
- Feasibility Studies
- Female
- Head and Neck Neoplasms
(radiotherapy)
- Humans
- Hypoxia
(prevention & control)
- Male
- Middle Aged
- Niacinamide
(administration & dosage)
- Oxygen
(administration & dosage)
- Radiation Injuries
(etiology)
- Radiation-Sensitizing Agents
(therapeutic use)
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