• 8/4/2007
  • Pittsburgh, PA
  • SS Agarwala et al.
  • Annals of Oncology 2007 18(7):1224-1229

Background:
Our goal was to evaluate long-term efficacy outcomes of patients with squamous cell carcinoma of the head and neck (SCCHN) treated with carboplatin, paclitaxel (Taxol) and radiotherapy.

Patients and methods:
We conducted a phase II trial in inoperable patients with locally advanced SCCHN. Carboplatin 100 mg/m2 and paclitaxel 40 mg/m2 were administered i.v. once a week during external beam radiation therapy (180 cGy per fraction) for 6–7 weeks. Interstitial brachytherapy was used as a boost in selected patients with primary malignancies of the oral cavity and the oropharynx.

Results:
Fifty-five patients were enrolled. Fifty-two patients (95%) had stage IV and 51 (93%) had technically unresectable disease; 62% had an oropharyngeal primary site. Twenty-one patients underwent brachytherapy boost. Grade 3 or 4 mucositis occurred in 30% of patients. One death occurred during treatment that was related to complications of gastrostomy tube placement. Forty of 50 assessable patients (80%) had an objective response, with a complete response rate of 52%. With a median follow-up of 69 months for surviving patients, the 5-year progression-free survival was 36% and the 5-year overall survival was 35%. Two of the 18 long-term survivors of >50 months were gastrostomy tube feeding dependent. Patients undergoing brachytherapy boost (n = 21) had similar outcomes compared with the rest of the patients. In multivariate analysis, baseline hemoglobin levels and N stage were predictive of survival.

Conclusion:
Treatment with concurrent carboplatin, paclitaxel and radiation is safe and offers curative potential for poor prognosis patients with locally advanced SCCHN.

Authors:
SS Agarwala1, E Cano2, DE Heron2, J Johnson3, E Myers3, V Sandulache1, S Bahri2, R Ferris3, Y Wang4 and A Argiris1,

Authors’ affiliations:
1 Division of Hematology/Oncology, Department of Medicine
2 Department of Radiation Oncology
3 Department of Otolaryngology
4 Department of Biostatistics, University of Pittsburgh and Head and Neck Cancer Program of the University of Pittsburgh Cancer Institute, Pittsburgh, PA, USA