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KMID : 0377220020270010090
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Medical Journal of Chosun Univercity
2002 Volume.27 No. 1 p.90 ~ p.99
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Chemoradiotherapy in poor prognostic head and neck cancer
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Cho Young-Shin
Park Yu-Hoan
Kim Won
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Abstract
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Background and Objectives: Satisfactory results have not been obtained with recent therapeutic methods for advanced or recurrent head and neck cancer. Simultaneous chemoradiotherapy has the purposes of overcoming radiation resistance, which is the cause of local treatment failure and of early treatment for distant micrometastasis, which is the cause of systemic treatment failure. Thus, we investigated effects and complications of chemoradiotherapy in head and neck cancer.
Materials and Methods: We examined the effectiveness of the simultaneous chemoradiotherapy in 22 histologically confirmed patients with head and neck cancer. Group 1 included 9 patients who have recurrent head and neck cancer after radical treatment and group 2 included 13 patients who have advanced head and neck cancer. We decided to perform chemotherapy with cisplatin (or leucovorin), hydroxyurea, and 5-fluorouracil and daily radiation therapy with 180-200 cGy every other week.
Results: The median follow-up period was 32 months. In those patients treated, the response rate was 80%(12/15) and complete response rate was 60%(9/15). Patients in group 1 showed a low response rate with 60%(3/5) whereas those in group 2 showed a high response rate with 90%(9/10) after treatment. The mean period of disease progression was 4.4 months for the patients in group 1 and was beyond the end point of follow up period in group 2. Although 5 out of 9 patients failed locally, those in group 2 showed no local failure. Hematologic toxicity was the most common complication in the treatment. Mucositis was the second significant complication and it was expressed more during the period when leucovorin was included in the treatment.
Conclusion: It is thought that simultaneous chemoradiotherapy is more effective than previous therapeutic methods in treatment of those patients with head and neck cancer with poor prognosis. Additional investigations on the survival rate and the causes of unresponsiveness to chemoradiotherapy remains to be done in the future.
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KEYWORD
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Chemoradiation therapy, Head and neck cancer, Micrometastasis
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