Phase I trial of tirapazamine, cisplatin, and concurrent accelerated boost reirradiation in patients with recurrent head and neck cancer.

Détails

ID Serval
serval:BIB_9158A41C9974
Type
Article: article d'un périodique ou d'un magazine.
Collection
Publications
Titre
Phase I trial of tirapazamine, cisplatin, and concurrent accelerated boost reirradiation in patients with recurrent head and neck cancer.
Périodique
International Journal of Radiation Oncology, Biology, Physics
Auteur⸱e⸱s
Cohen E.E., Rosine D., Haraf D.J., Loh E., Shen L., Lusinchi A., Vokes E.E., Bourhis J.
ISSN
0360-3016 (Print)
ISSN-L
0360-3016
Statut éditorial
Publié
Date de publication
2007
Peer-reviewed
Oui
Volume
67
Numéro
3
Pages
678-684
Langue
anglais
Notes
Publication types: Clinical Trial, Phase I ; Journal Article ; Multicenter Study ; Research Support, N.I.H., Extramural ; Research Support, Non-U.S. Gov'tPublication Status: ppublish
Résumé
PURPOSE: Reirradiation (re-RT) with concurrent chemotherapy offers a therapeutic option in patients who have locoregional recurrence of head and neck cancer (HNC). The hypoxic cell sensitizer, tirapazamine (TPZ), has demonstrated promising results in first-line therapy for HNC. This phase I trial was designed to test the feasibility of giving TPZ in the re-RT setting.
METHODS AND MATERIALS: Patients with recurrent HNC who received prior radiotherapy (RT) were enrolled and received TPZ (260 mg/m2) and cisplatin (50 mg/m2) Weeks 1, 3, and 5 concurrently with RT (72 Gy, 42 fractions over 6 weeks). TPZ (160 mg/m2) alone was added on Days 1, 3, and 5 of Week 2 (cohort 1) or Weeks 2 and 4 (cohort 2).
RESULTS: Twenty-five subjects were enrolled, 7 and 18 on cohorts 1 and 2, respectively. Significant toxicities included Grade 3 dermatitis (20%) and Grade 3 mucositis (40%). Dose-limiting toxicity was observed on cohort 2 (1 patient with aspiration pneumonia). Four deaths occurred during treatment. Two fatalities occurred after completing therapy as a result of carotid artery rupture. With a minimum and median follow-up of 14 and 24 months, respectively, median overall survival was 14 months with actuarial 1-year and 2-year survival of 56% and 27%, respectively.
CONCLUSION: Reirradiation with concomitant chemotherapy including TPZ in patients with unresectable recurrent HNC is feasible and results in long-term survival in a significant proportion of patients.
Mots-clé
Adult, Aged, Antineoplastic Combined Chemotherapy Protocols/adverse effects, Antineoplastic Combined Chemotherapy Protocols/therapeutic use, Carcinoma, Squamous Cell/drug therapy, Carcinoma, Squamous Cell/radiotherapy, Cisplatin/administration & dosage, Cisplatin/adverse effects, Combined Modality Therapy/adverse effects, Combined Modality Therapy/methods, Confidence Intervals, Feasibility Studies, Female, Head and Neck Neoplasms/drug therapy, Head and Neck Neoplasms/radiotherapy, Humans, Male, Middle Aged, Neoplasm Recurrence, Local/drug therapy, Neoplasm Recurrence, Local/radiotherapy, Radiation-Sensitizing Agents/administration & dosage, Radiation-Sensitizing Agents/adverse effects, Radiotherapy Dosage, Retreatment, Triazines/administration & dosage, Triazines/adverse effects
Pubmed
Web of science
Création de la notice
01/12/2014 18:30
Dernière modification de la notice
20/08/2019 15:54
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