A phase II randomized trial comparing neoadjuvant chemotherapy followed by concurrent chemoradiotherapy versus concurrent chemoradiotherapy alone in advanced squamous cell carcinoma of the pharynx or larynx
Background: To clarify the effect of induction chemotherapy (ICT) in patients with advanced pharyngeal and laryngeal squamous cell carcinoma (PLSCC) treated with concurrent chemoradiotherapy (CCRT). Methods: Patients with treatment-naïve nonmetastatic advanced PLSCC were stratified according to dise...
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| Format: | Article |
| Language: | English |
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Elsevier
2018-04-01
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| Series: | Biomedical Journal |
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| Online Access: | http://www.sciencedirect.com/science/article/pii/S2319417017302718 |
| _version_ | 1797999756748783616 |
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| author | Pei-Wei Huang Chien-Yu Lin Chia-Hsun Hsieh Cheng-Lung Hsu Kang-Hsing Fan Shiang-Fu Huang Chun-Ta Liao Shu-Kung Ng Tzu-Chen Yen Joseph Tung-Chieh Chang Hung-Ming Wang |
| author_facet | Pei-Wei Huang Chien-Yu Lin Chia-Hsun Hsieh Cheng-Lung Hsu Kang-Hsing Fan Shiang-Fu Huang Chun-Ta Liao Shu-Kung Ng Tzu-Chen Yen Joseph Tung-Chieh Chang Hung-Ming Wang |
| author_sort | Pei-Wei Huang |
| collection | DOAJ |
| description | Background: To clarify the effect of induction chemotherapy (ICT) in patients with advanced pharyngeal and laryngeal squamous cell carcinoma (PLSCC) treated with concurrent chemoradiotherapy (CCRT).
Methods: Patients with treatment-naïve nonmetastatic advanced PLSCC were stratified according to disease stage (III or IV) and resectability before being randomized to either a ICT/CCRT or CCRT arm. A cisplatin/tegafur-uracil/leucovorin regimen was administered during ICT and CCRT. The primary end point was overall survival (OS).
Results: We enrolled 151 patients during December 2006 to February 2011. The median follow-up of surviving patients was 54.5 months. The ICT/CCRT arm included more patients with hypopharynx cancer (57.1% vs 40.5%, p = 0.09) and N2 or N3 diseases (85.7% vs 74.4%, p = 0.02). In the ICT/CCRT and CCRT arms, the 5-year OS was 48.1% and 53.2% (p = 0.45); progression-free survival (PFS) was 31.8% and 55.6% (p = 0.015); and locoregional control (LRC) was 37.7% and 56.2% (p = 0.026), respectively. The adverse events and compliance to radiotherapy were similar. However, the proportion of patients receiving a total dose of cisplatin during CCRT <150 mg/m2 was higher in the ICT/CCRT arm (46.8% vs 16.2%; p = 0.000) and independently predicted poorer PFS and LRC in multivariate analysis.
Conclusion: OS did not vary between the ICT/CCRT and CCRT arms. However, poorer compliance to CCRT and inferior LRC and PFS were observed in the ICT/CCRT arm. Optimizing the therapeutic ratio in both ICT and CCRT settings are necessary for developing a sequential strategy for patients with advanced-stage PLSCC. |
| first_indexed | 2024-04-11T11:09:48Z |
| format | Article |
| id | doaj.art-8cfcdcc773144e9d929e119124a4d8d1 |
| institution | Directory Open Access Journal |
| issn | 2319-4170 |
| language | English |
| last_indexed | 2024-04-11T11:09:48Z |
| publishDate | 2018-04-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Biomedical Journal |
| spelling | doaj.art-8cfcdcc773144e9d929e119124a4d8d12022-12-22T04:27:47ZengElsevierBiomedical Journal2319-41702018-04-0141212913610.1016/j.bj.2018.04.003A phase II randomized trial comparing neoadjuvant chemotherapy followed by concurrent chemoradiotherapy versus concurrent chemoradiotherapy alone in advanced squamous cell carcinoma of the pharynx or larynxPei-Wei Huang0Chien-Yu Lin1Chia-Hsun Hsieh2Cheng-Lung Hsu3Kang-Hsing Fan4Shiang-Fu Huang5Chun-Ta Liao6Shu-Kung Ng7Tzu-Chen Yen8Joseph Tung-Chieh Chang9Hung-Ming Wang10Division of Medical Oncology, Department of Internal Medicine, Chang Gung Memorial Hospital at Linkou, Taoyuan, TaiwanDepartment of Radiation Oncology, Chang Gung Memorial Hospital at Linkou, Taoyuan, TaiwanDivision of Medical Oncology, Department of Internal Medicine, Chang Gung Memorial Hospital at Linkou, Taoyuan, TaiwanDivision of Medical Oncology, Department of Internal Medicine, Chang Gung Memorial Hospital at Linkou, Taoyuan, TaiwanDepartment of Radiation Oncology, Chang Gung Memorial Hospital at Linkou, Taoyuan, TaiwanSection of Head and Neck Surgery, Department of Otorhinolaryngology, Chang Gung Memorial Hospital at Linkou, Taoyuan, TaiwanSection of Head and Neck Surgery, Department of Otorhinolaryngology, Chang Gung Memorial Hospital at Linkou, Taoyuan, TaiwanDepartment of Diagnostic Radiology, Chang Gung Memorial Hospital at Linkou, Taoyuan, TaiwanDepartment of Nuclear Medicine and Molecular Imaging Center, Chang Gung Memorial Hospital at Linkou, Taoyuan, TaiwanDepartment of Radiation Oncology, Chang Gung Memorial Hospital at Linkou, Taoyuan, TaiwanDivision of Medical Oncology, Department of Internal Medicine, Chang Gung Memorial Hospital at Linkou, Taoyuan, TaiwanBackground: To clarify the effect of induction chemotherapy (ICT) in patients with advanced pharyngeal and laryngeal squamous cell carcinoma (PLSCC) treated with concurrent chemoradiotherapy (CCRT). Methods: Patients with treatment-naïve nonmetastatic advanced PLSCC were stratified according to disease stage (III or IV) and resectability before being randomized to either a ICT/CCRT or CCRT arm. A cisplatin/tegafur-uracil/leucovorin regimen was administered during ICT and CCRT. The primary end point was overall survival (OS). Results: We enrolled 151 patients during December 2006 to February 2011. The median follow-up of surviving patients was 54.5 months. The ICT/CCRT arm included more patients with hypopharynx cancer (57.1% vs 40.5%, p = 0.09) and N2 or N3 diseases (85.7% vs 74.4%, p = 0.02). In the ICT/CCRT and CCRT arms, the 5-year OS was 48.1% and 53.2% (p = 0.45); progression-free survival (PFS) was 31.8% and 55.6% (p = 0.015); and locoregional control (LRC) was 37.7% and 56.2% (p = 0.026), respectively. The adverse events and compliance to radiotherapy were similar. However, the proportion of patients receiving a total dose of cisplatin during CCRT <150 mg/m2 was higher in the ICT/CCRT arm (46.8% vs 16.2%; p = 0.000) and independently predicted poorer PFS and LRC in multivariate analysis. Conclusion: OS did not vary between the ICT/CCRT and CCRT arms. However, poorer compliance to CCRT and inferior LRC and PFS were observed in the ICT/CCRT arm. Optimizing the therapeutic ratio in both ICT and CCRT settings are necessary for developing a sequential strategy for patients with advanced-stage PLSCC.http://www.sciencedirect.com/science/article/pii/S2319417017302718Head and neck cancerChemoradiotherapyInduction chemotherapy |
| spellingShingle | Pei-Wei Huang Chien-Yu Lin Chia-Hsun Hsieh Cheng-Lung Hsu Kang-Hsing Fan Shiang-Fu Huang Chun-Ta Liao Shu-Kung Ng Tzu-Chen Yen Joseph Tung-Chieh Chang Hung-Ming Wang A phase II randomized trial comparing neoadjuvant chemotherapy followed by concurrent chemoradiotherapy versus concurrent chemoradiotherapy alone in advanced squamous cell carcinoma of the pharynx or larynx Biomedical Journal Head and neck cancer Chemoradiotherapy Induction chemotherapy |
| title | A phase II randomized trial comparing neoadjuvant chemotherapy followed by concurrent chemoradiotherapy versus concurrent chemoradiotherapy alone in advanced squamous cell carcinoma of the pharynx or larynx |
| title_full | A phase II randomized trial comparing neoadjuvant chemotherapy followed by concurrent chemoradiotherapy versus concurrent chemoradiotherapy alone in advanced squamous cell carcinoma of the pharynx or larynx |
| title_fullStr | A phase II randomized trial comparing neoadjuvant chemotherapy followed by concurrent chemoradiotherapy versus concurrent chemoradiotherapy alone in advanced squamous cell carcinoma of the pharynx or larynx |
| title_full_unstemmed | A phase II randomized trial comparing neoadjuvant chemotherapy followed by concurrent chemoradiotherapy versus concurrent chemoradiotherapy alone in advanced squamous cell carcinoma of the pharynx or larynx |
| title_short | A phase II randomized trial comparing neoadjuvant chemotherapy followed by concurrent chemoradiotherapy versus concurrent chemoradiotherapy alone in advanced squamous cell carcinoma of the pharynx or larynx |
| title_sort | phase ii randomized trial comparing neoadjuvant chemotherapy followed by concurrent chemoradiotherapy versus concurrent chemoradiotherapy alone in advanced squamous cell carcinoma of the pharynx or larynx |
| topic | Head and neck cancer Chemoradiotherapy Induction chemotherapy |
| url | http://www.sciencedirect.com/science/article/pii/S2319417017302718 |
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