Weekly cisplatin versus standard three-weekly cisplatin in concurrent chemoradiotherapy of head and neck cancer: the Baskent University experience.
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BACKGROUND: The majority of patients with head and neck cancer are treated with concurrent chemoradiotherapy. However, toxicity is substantial so that alternate schedules of cisplatin have been tried to overcome this problem. No formal comparison, however, has been reported between alternate schedules and reference regimen. PATIENTS AND METHODS: Fifty-five eligible patients treated with concurrent chemoradiotherapy were retrospectively analyzed. The patients treated with weekly cisplatin were defined as group A, while the patients treated with standard regimen were defined as group B. Basic demographics and clinical characteristics', overall survival rate, locoregional or systemic relapse rates, and time to local/systemic relapse were recorded. RESULTS: One, two, and three-year probability of survival in groups A and B were 75% to 65% after one year, 63% to 56%after two, and 63% to 52% after three, respectively. Although time to local and systemic relapse was higher in group B as compared to group A, a statistical analysis was failed to show any significant difference. Furthermore, there was no significant difference between groups with respect to major toxicity. CONCLUSION: In patients with head and neck cancer, concurrent chemoradiotherapy with weekly cisplatin might be as effective as concurrent chemoradiotherapy with bolus cisplatin. (+info)
The radiotherapy with methotrexate, vinblastine, doxorubicin, and cisplatin treatment is an effective therapeutic option in patients with advanced or metastatic bladder cancer.
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The objectives of this study were to determine the tolerability of combined use of methotrexate, vinblastine, doxorubicin, and cisplatin (MVAC) with external beam radiation therapy (EBRT) and to access the efficacy in patients with locally advanced or metastatic bladder cancer. From December 2000 to November 2010, 30 eligible patients were enrolled in this study. After receiving one cycle of MVAC treatment, all patients received EBRT with a half dose of MVAC treatment followed by two more cycles of chemotherapy. A standard fractionation with daily dose of 1.8-2.0 Gy was used, with the total dose up to 60 Gy over 5-6 weeks. The four-field box technique was utilized for radiation fields. Thirteen patients (43%) had complete response and 11 (37%) had partial response, with an overall response rate of 80%. The median overall survival and progression-free survival was 25.5 months and 12.8 months, respectively. In the complete-response patients, median overall survival was 37.1 months. Grade 3 or 4 neutropenia occurred in 25 patients (83%), but there were no severe infections. One patient (3%) had hemorrhagic radiation cystitis. There were no treatment-related deaths. Combined use of MVAC treatment with EBRT is a favorable therapeutic option for patients with advanced or metastatic bladder carcinoma. Given the safety and benefit profile found in this study, appropriate case selection is warranted in the future. (+info)
Assessment of peri- and postoperative complications and Karnofsky-performance status in head and neck cancer patients after radiation or chemoradiation that underwent surgery with regional or free-flap reconstruction for salvage, palliation, or to improve function.
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Phase II and pharmacogenomics study of enzastaurin plus temozolomide during and following radiation therapy in patients with newly diagnosed glioblastoma multiforme and gliosarcoma.
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