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Carboplatin and tegafur-uracil concomitant with standard radiotherapy in the management of locally advanced head and neck cancer

Carboplatino y tegafur uracilo concomitante con radioterapia como tratamiento de tumores de cabeza y cuello localmente avanzados

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Abstract

Introduction

We undertook a prospective study to determine the feasibility, toxicity, response and survival rate of simultaneous chemotherapy (CT) and radiotherapy (RT) for locally-advanced head & neck cancer.

Material and methods

Fifty eight patients were treated with carboplatin (i.e. 100 mg/m2) weekly, tegafur-uracil (UFT) (oral 400 mg/m2) daily and simultaneous treatment with a cobalt-60 source of radiation (total dose 65–70 Gy).

Results

Forty six patients (79%) received the total dose of RT while CT was delayed or reduced in 31 patients (53%). Grade 3–4 toxicity observed was mucositis in 27 (47%), leukopenia in 10 (17%), anaemia in 5 (9%), and diarrhoea in 4 (7%) patients. The objective response rate was 74%; 24 complete response (41%) and 19 partial response (33%). Overall, there are 11 patients (19%) disease-free, 7 (12%) alive with disease, 35 have died of progressive disease (60%) and 3 (5%) from other causes. There were 2 toxic deaths (3%). Median time to progression was 10 months and median survival was 18.4 months.

Conclusions

The use of carboplatin and UFT concomitant with radiotherapy has, in our study, a slightly lower activity than other chemo-radiotherapy protocols, especially with respect to complete responses, but with no significant differences in overall survival or disease-free survival rates.

Resumen

Introducción

Presentamos un estudio para determinan la toxicidad y actividad tanto en respuesta como en supervivencia de un esquema de quimioterapia (QT) concomitante con radioterapia (RT) en pacientes con tumores localmente avanzados de cabeza y cuello.

Material y métodos

Cincuenta y ocho pacientes recibieron tratamiento con carboplatino 100 mg/m2 por vía intravenosa semanal y tegafur-uracilo (UFT) 400 mg/m2 por vía oral diario junto a radioterapia mediante fuentes de Cobalto-60 (dosis total de 65–70 Gy).

Resultados

Cuarenta y seis pacientes (79%) recibieron la dosis completa de RT y la QT debió retraerse o reducirse en 31 pacientes (53%). La toxicidad grado 3–4 fue mucositis en 27 pacientes (47%), leucopenia en 10 (17%), anemia en 5 (9%), y diarrea en 4 (7%). La tasa de respuesta objetiva fue de un 74% con 24 respuestas completas (41%) y 19 respuestas parciales (33%). Once pacientes (19%) permanecen libres de enfermedad y 7 (12%) están vivos con enfermedad. Treinta y cinco han muerto por la enfermedad (60%), 3 (5%) por otras causas y hubo 2 muertes por toxicidad (3%). La mediana de tiempo a la progresión fue de 10 meses y la mediana de supervivencia fue de 18.4 meses.

Conclusiones

El uso de carboplatino y UFT concomitante con RT presenta una menor actividad que otros esquemas de QT/RT sobre todo en la capacidad de lograr respuestas completas; de cualquier manera ello no parece influir en la supervivencia global o en la supervivencia libre de enfermedad.

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Authors and Affiliations

  1. Medical Oncology Unit, University Hospital La Fe, Avda Campanar 21, 46009, Valencia, Spain

    Ángel Segura Huerta, Roberto Díaz-Beveridge, José A. Pérez-Fidalgo, Verónica Calderero Aragón, Miguel Pastor Borgoñón, Jorge Aparicio Urtasun & Joaquín Montalar Salcedo

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  1. Ángel Segura Huerta
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  2. Roberto Díaz-Beveridge
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Correspondence to Ángel Segura Huerta.

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Huerta, Á.S., Díaz-Beveridge, R., Pérez-Fidalgo, J.A. et al. Carboplatin and tegafur-uracil concomitant with standard radiotherapy in the management of locally advanced head and neck cancer. Clin Transl Oncol 7, 23–28 (2005). https://doi.org/10.1007/BF02710022

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