Fortschritte in der Therapie von Kopf- und Halstumoren. 2. Teil: Radiochemotherapie [Advances in the treatment of head and neck tumors. 2. Radiochemotherapy].
Details
Serval ID
serval:BIB_6A813727D1E8
Type
Article: article from journal or magazin.
Publication sub-type
Review (review): journal as complete as possible of one specific subject, written based on exhaustive analyses from published work.
Collection
Publications
Institution
Title
Fortschritte in der Therapie von Kopf- und Halstumoren. 2. Teil: Radiochemotherapie [Advances in the treatment of head and neck tumors. 2. Radiochemotherapy].
Journal
Strahlentherapie und Onkologie
ISSN
0179-7158 (Print)
ISSN-L
0179-7158
Publication state
Published
Issued date
03/1995
Peer-reviewed
Oui
Volume
171
Number
3
Pages
140-148
Language
german
Notes
Publication types: Comparative Study ; English Abstract ; Journal Article ; Review
Publication Status: ppublish
Publication Status: ppublish
Abstract
PURPOSE: Local recurrences are one of the main reasons of failure of therapy for locally advanced cancer of the head and neck. Concomitant chemoradiotherapy and accelerated radiation techniques are supposed to improve the locoregional control rates.
METHODS: We review the theoretical background and the most important larger clinical trials using concomitant or alternating chemoradiotherapy. The data of alternative fractionation schedules are also briefly reviewed.
RESULTS: For many chemotherapy agents a radiosensitizing effect has been shown. Significantly improved locoregional control has been shown for mitomycin C, cisplatin and 5-fluorouracil. Most studies failed to show improved survival. The major factor for this negative result is the common multimorbidity of patients leading to death of other causes then cancer.
CONCLUSION: Concomitant, alternating or split course chemoradiotherapy can improve locoregional control. Improved survival has been shown rarely. Confirmatory studies are necessary before adapting this approach in daily practice outside clinical trials. Accelerated hyperfractionation with or without chemotherapy may further improve the control rates. Reirradiation with concomitant chemotherapy in recurrent tumors achieves complete response rates of over 40%.
METHODS: We review the theoretical background and the most important larger clinical trials using concomitant or alternating chemoradiotherapy. The data of alternative fractionation schedules are also briefly reviewed.
RESULTS: For many chemotherapy agents a radiosensitizing effect has been shown. Significantly improved locoregional control has been shown for mitomycin C, cisplatin and 5-fluorouracil. Most studies failed to show improved survival. The major factor for this negative result is the common multimorbidity of patients leading to death of other causes then cancer.
CONCLUSION: Concomitant, alternating or split course chemoradiotherapy can improve locoregional control. Improved survival has been shown rarely. Confirmatory studies are necessary before adapting this approach in daily practice outside clinical trials. Accelerated hyperfractionation with or without chemotherapy may further improve the control rates. Reirradiation with concomitant chemotherapy in recurrent tumors achieves complete response rates of over 40%.
Keywords
Cisplatin/therapeutic use, Combined Modality Therapy, Fluorouracil/therapeutic use, Head and Neck Neoplasms/drug therapy, Head and Neck Neoplasms/mortality, Humans, Mitomycin/therapeutic use, Neoplasm Recurrence, Local/prevention & control, Palliative Care, Radiation-Sensitizing Agents, Radiotherapy Dosage, Randomized Controlled Trials as Topic
Pubmed
Create date
28/01/2008 9:39
Last modification date
20/08/2019 15:25
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