Multimodality treatment including postoperative radiation and concurrent chemotherapy with weekly docetaxel is feasible and effective in patients with oral and oropharyngeal cancer.

Abstract

BACKGROUND:

To examine the feasibility and efficacy of weekly docetaxel with concurrent radiation as postoperative treatment in a multimodality approach to oral and oropharyngeal cancer.

PATIENTS AND METHODS:

94 patients (Table 1) with primary resectable squamous cell carcinoma of the oral cavity and oropharynx (UICC stage I 14%, II 15%, III 18%, IV 53%; Table 2) were treated with a multimodality therapy program consisting of neoadjuvant intra-arterial high-dose chemotherapy (cisplatin 150 mg/m(2) with parallel systemic sodium thiosulfate 9 g/m(2) for neutralization), followed by surgery of the primary and neck, and postoperative concurrent radiation and chemotherapy with weekly docetaxel (20-30 mg/m(2); Table 3). Chronic toxicities were followed over a period of 5 years.

RESULTS:

At a median follow-up of 4 years, the 5-year survival rate for all 94 patients was 80%, and disease-free survival was 73% (Figures 1 and 2). Among patients with advanced disease (stage III and IV), survival was 83 and 59%, respectively (Figure 4). Grade 3 and 4 mucositis was the main acute toxicity necessitating supportive care. Long-term toxicity appears to be moderate (Table 4). The maximum tolerated dose of weekly docetaxel was 25 mg/m(2).

CONCLUSIONS:

Concurrent radiation and chemotherapy with weekly docetaxel is a feasible postoperative treatment in a multimodality approach to oral and oropharyngeal cancer, resulting in high overall and disease-free survival. This approach warrants further evaluation in prospective randomized trials.

• Authors: Adorján F Kovács, Stephan Mose, Heinz D Böttcher, Klaus Bitter
• Journal: Strahlentherapie und Onkologie : Organ der Deutschen Rontgengesellschaft ... [et al] (Strahlenther Onkol) Vol. 181 Issue 1 Pg. 26-34 (Jan 2005) ISSN: 0179-7158 [Print] Germany
• PMID: 15660190 (Publication Type: Clinical Trial, Clinical Trial, Phase II, Comparative Study, Journal Article, Research Support, Non-U.S. Gov't)

Chemical References

• Antineoplastic Agents
• Antineoplastic Agents, Phytogenic
• Taxoids
• Thiosulfates
• Docetaxel
• sodium thiosulfate
• Cisplatin

Topics

• Adult
• Aged
• Antineoplastic Agents (administration & dosage, therapeutic use)
• Antineoplastic Agents, Phytogenic (administration & dosage)
• Carcinoma, Squamous Cell (drug therapy, mortality, pathology, radiotherapy, surgery, therapy)
• Cisplatin (administration & dosage, therapeutic use)
• Combined Modality Therapy
• Disease-Free Survival
• Docetaxel
• Feasibility Studies
• Female
• Follow-Up Studies
• Head (pathology)
• Head and Neck Neoplasms (drug therapy, mortality, pathology, radiotherapy, surgery, therapy)
• Humans
• Infusions, Intravenous
• Injections, Intra-Arterial
• Male
• Middle Aged
• Neck (pathology)
• Neck Dissection
• Neoadjuvant Therapy
• Neoplasm Staging
• Postoperative Care
• Radiotherapy Dosage
• Radiotherapy, Adjuvant
• Survival Analysis
• Taxoids (administration & dosage)
• Thiosulfates (administration & dosage, therapeutic use)
• Time Factors
• Treatment Outcome