nach oben

Strahlentherapie und Onkologie

Erschienen in:

01.03.2012 | Original article

Re-irradiation combined with capecitabine in locally recurrent squamous cell carcinoma of the head and neck

A prospective phase II trial

verfasst von: L. Vormittag, C. Lemaire, D. Radonjic, G. Kornek, E. Selzer, MD

Erschienen in: Strahlentherapie und Onkologie | Ausgabe 3/2012

Einloggen, um Zugang zu erhalten

Abstract

Background

We performed a prospective phase II trial to investigate the safety and efficacy of radiotherapy combined with capecitabine in patients suffering from a recurrence of a squamous cell carcinoma of the head and neck (SCCHN) within a previously irradiated field.

Patients and methods

A total of 31 evaluable patients with recurrent SCCHN received re-irradiation with a total dose of 50 Gy (25 fractions over 5 weeks) up to a maximum of 60 Gy combined with 900 mg/m²/day capecitabine given on the days of radiotherapy.

Results

The median time to relapse after the first course of radiotherapy was 15 months. The overall response rate in our study was 68% including 6 patients with a complete response. The median overall survival was 8.4 months. Grade 3 or 4 mucositis occurred in 4 patients and 1 patient, respectively. No grade 4 hematological toxicities were observed; 1 patient had grade 3 anemia. The cumulative median lifetime dose was 116 Gy.

Conclusion

Capecitabine combined with re-irradiation is a well-tolerated treatment in patients with recurrent SCCHN. In light of its good tolerability, it appears to be a potential option for patients with a reduced performance status and may also serve as a basis for novel treatment concepts, such as in combination with targeted therapies.

Salama JK, Vokes EE (2008) Concurrent chemotherapy and re-irradiation for locoregionally recurrent head and neck cancer. Semin Oncol 35:251–261PubMedCrossRef

Wong SJ, Machtay M, Li Y (2006) Locally recurrent, previously irradiated head and neck cancer: concurrent re-irradiation and chemotherapy, or chemotherapy alone? J Clin Oncol 24:2653–2658PubMedCrossRef

Kao J, Garofalo MC, Milano MT et al (2003) Reirradiation of recurrent and second primary head and neck malignancies: a comprehensive review. Cancer Treat Rev 29:21–30PubMedCrossRef

Salama JK, Vokes EE, Chmura SJ et al (2006) Long-term outcome of concurrent chemotherapy and reirradiation for recurrent and second primary head-and-neck squamous cell carcinoma. Int J Radiat Oncol Biol Phys 64:382–391PubMedCrossRef

Milano MT, Vokes EE, Salama JK et al (2005) Twice-daily reirradiation for recurrent and second primary head-and-neck cancer with gemcitabine, paclitaxel, and 5-fluorouracil chemotherapy. Int J Radiat Oncol Biol Phys 61:1096–1106PubMedCrossRef

Biagioli MC, Harvey M, Roman E et al (2007) Intensity-modulated radiotherapy with concurrent chemotherapy for previously irradiated, recurrent head and neck cancer. Int J Radiat Oncol Biol Phys 69:1067–1073PubMedCrossRef

Haraf DJ, Weichselbaum RR, Vokes EE (1996) Re-irradiation with concomitant chemotherapy of unresectable recurrent head and neck cancer: a potentially curable disease. Ann Oncol 7:913–918PubMedCrossRef

Kasperts N, Slotman B, Leemans CR, Langendijk JA (2005) A review on re-irradiation for recurrent and second primary head and neck cancer. Oral Oncol 41:225–243PubMedCrossRef

Chopra S, Gupta T, Agarwal JP et al (2006) Re-irradiation in the management of isolated neck recurrences: current status and recommendations. Radiother Oncol 81:1–8PubMedCrossRef

10.

Garofalo MC, Haraf DJ (2002) Reirradiation: a potentially curative approach to locally or regionally recurrent head and neck cancer. Curr Opin Oncol 14:330–333PubMedCrossRef

11.

Langendijk JA, Bourhis J (2007) Reirradiation in squamous cell head and neck cancer: recent developments and future directions. Curr Opin Oncol 19:202–209PubMedCrossRef

12.

Nagar YS, Singh S, Datta NR (2004) Chemo-reirradiation in persistent/recurrent head and neck cancers. Jpn J Clin Oncol 34:61–68PubMedCrossRef

13.

Berger B, Belka C, Weinmann M et al (2010) Reirradiation with alternating docetaxel-based chemotherapy for recurrent head and neck squamous cell carcinoma: update of a single-center prospective phase II protocol. Strahlenther Onkol 186:255–261PubMedCrossRef

14.

Platteaux N, Dirix P, Vanstraelen B, Nuyts S (2011) Outcome after re-irradiation of head and neck cancer patients. Strahlenther Onkol 187(1):23–31PubMedCrossRef

15.

Goodwin WJ Jr (2000) Salvage surgery for patients with recurrent squamous cell carcinoma of the upper aerodigestive tract: when do the ends justify the means? Laryngoscope 110:1–18PubMedCrossRef

16.

Parsons JT, Mendenhall WM, Stringer SP et al (1995) Salvage surgery following radiation failure in squamous cell carcinoma of the supraglottic larynx. Int J Radiat Oncol Biol Phys 32:605–609PubMedCrossRef

17.

Hong WK, Bromer R (1983) Chemotherapy in head and neck cancer. N Engl J Med 308:75–79PubMedCrossRef

18.

Siu LL, Soulieres D, Chen EX et al (2007) Phase I/II trial of erlotinib and cisplatin in patients with recurrent or metastatic squamous cell carcinoma of the head and neck: a Princess Margaret Hospital phase II consortium and National Cancer Institute of Canada Clinical Trials Group Study. J Clin Oncol 25:2178–2183PubMedCrossRef

19.

Shin DM, Khuri FR, Glisson BS et al (2001) Phase II study of paclitaxel, ifosfamide, and carboplatin in patients with recurrent or metastatic head and neck squamous cell carcinoma. Cancer 91:1316–1323PubMedCrossRef

20.

Burtness B, Goldwasser MA, Flood W et al (2005) Phase III randomized trial of cisplatin plus placebo compared with cisplatin plus cetuximab in metastatic/recurrent head and neck cancer: an Eastern Cooperative Oncology Group study. J Clin Oncol 23:8646–8654PubMedCrossRef

21.

Smith RE, Thornton DE, Allen J (1995) A phase II trial of paclitaxel in squamous cell carcinoma of the head and neck with correlative laboratory studies. Semin Oncol 22:41–46PubMed

22.

Dreyfuss AI, Clark JR, Norris CM et al (1996) Docetaxel: an active drug for squamous cell carcinoma of the head and neck. J Clin Oncol 14:1672–1678PubMed

23.

Forastiere AA, Shank D, Neuberg D et al (1998) Final report of a phase II evaluation of paclitaxel in patients with advanced squamous cell carcinoma of the head and neck: an Eastern Cooperative Oncology Group trial (PA390). Cancer 82:2270–2274PubMedCrossRef

24.

Hitt R, Jimeno A, Millán JM et al (2004) Phase II trial of dose-dense paclitaxel, cisplatin, 5-fluorouracil, and leucovorin with filgrastim support in patients with squamous cell carcinoma of the head and neck. Cancer 101:768–775PubMedCrossRef

25.

Chmura SJ, Milano MT, Haraf DJ (2004) Reirradiation of recurrent head and neck cancers with curative intent. Semin Oncol 31:816–821PubMedCrossRef

26.

Spencer SA, Harris J, Wheeler RH et al (2001) RTOG 96–10: reirradiation with concurrent hydroxyurea and 5-fluorouracil in patients with squamous cell cancer of the head and neck. Int J Radiat Oncol Biol Phys 51:1299–1304PubMedCrossRef

27.

Cooper JS, Pajak TF, Forastiere AA et al (2004) Postoperative concurrent radiotherapy and chemotherapy for high-risk squamous-cell carcinoma of the head and neck. N Engl J Med 350:1937–1944PubMedCrossRef

28.

Adelstein DJ, Li Y, Adams GL et al (2003) An intergroup phase III comparison of standard radiation therapy and two schedules of concurrent chemoradiotherapy in patients with unresectable squamous cell head and neck cancer. J Clin Oncol 21:92–98PubMedCrossRef

29.

Ben-Josef E (2007) Capecitabine and radiotherapy as neoadjuvant treatment for rectal cancer. Am J Clin Oncol 30:649–665PubMedCrossRef

30.

Czito BG, Willett CG, Bendell JC (2007) Combined-modality therapy for rectal cancer: future prospects. Clin Colorectal Cancer 6:625–633PubMedCrossRef

31.

Dunst J, Debus J, Rudat V et al (2008) Neoadjuvant capecitabine combined with standard radiotherapy in patients with locally advanced rectal cancer: mature results of a phase II trial. Strahlenther Onkol 184:450–456PubMedCrossRef

32.

Ofner D, Devries AF, Schaberl-Moser R et al (2011) Preoperative oxaliplatin, capecitabine, and external beam radiotherapy in patients with newly diagnosed, primary operable, cT₃NxM0, low rectal cancer: a phase II study. Strahlenther Onkol 187:100–107PubMedCrossRef

33.

Miwa M, Ura M, Nishida M et al (1998) Design of a novel oral fluoropyrimidine carbamate, capecitabine, which generates 5-fluorouracil selectively in tumours by enzymes concentrated in human liver and cancer tissue. Eur J Cancer 34:1274–1281PubMedCrossRef

34.

Sawada N, Ishikawa T, Sekiguchi F et al (1999) X-ray irradiation induces thymidine phosphorylase and enhances the efficacy of capecitabine (Xeloda) in human cancer xenografts. Clin Cancer Res 5:2948–2953PubMed

35.

Jegannathen A, Mais K, Sykes A et al (2011) Synchronous chemoradiotherapy in patients with locally advanced squamous cell carcinoma of the head and neck using capecitabine: a single-centre, open-label, single-group phase II study. Clin Oncol (R Coll Radiol) 23:149–158

36.

Anonymous (1995) LENT SOMA scales for all anatomic sites. Int J Radiat Oncol Biol Phys 31:1049–1091CrossRef

37.

Lee AW, Foo W, Law SC et al (1997) Reirradiation for recurrent nasopharyngeal carcinoma: factors affecting the therapeutic ratio and ways for improvement. Int J Radiat Oncol Biol Phys 38:43–52PubMedCrossRef

38.

Ang KK, Jiang GL, Feng Y et al (2001) Extent and kinetics of recovery of occult spinal cord injury. Int J Radiat Oncol Biol Phys 50:1013–1020PubMedCrossRef

39.

Lee AW, Foo W, Law SC et al (2000) Total biological effect on late reactive tissues following reirradiation for recurrent nasopharyngeal carcinoma. Int J Radiat Oncol Biol Phys 46:865–872PubMedCrossRef

40.

Grosu AL, Andratschke N, Nieder C, Molls M (2002) Retreatment of the spinal cord with palliative radiotherapy. Int J Radiat Oncol Biol Phys 52:1288–1292PubMedCrossRef

41.

Sminia P, Oldenburger F, Slotman BJ et al (2002) Re-irradiation of the human spinal cord. Strahlenther Onkol 178:453–456PubMedCrossRef

42.

Schultheiss TE (2008) The radiation dose-response of the human spinal cord. Int J Radiat Oncol Biol Phys 71:1455–1459PubMedCrossRef

43.

Nieder C, Grosu AL, Andratschke NH, Molls M (2005) Proposal of human spinal cord reirradiation dose based on collection of data from 40 patients. Int J Radiat Oncol Biol Phys 61:851–855PubMedCrossRef

44.

Weichselbaum RR, Beckett MA, Schwartz JL, Dritschilo A (1988) Radioresistant tumor cells are present in head and neck carcinomas that recur after radiotherapy. Int J Radiat Oncol Biol Phys 15:575–579PubMedCrossRef

45.

Levendag PC, Meeuwis CA, Visser AG (1992) Reirradiation of recurrent head and neck cancers: external and/or interstitial radiation therapy. Radiother Oncol 23:6–15PubMedCrossRef

46.

Teo PM, Kwan WH, Chan AT et al (1998) How successful is high-dose (> or = 60 Gy) reirradiation using mainly external beams in salvaging local failures of nasopharyngeal carcinoma? Int J Radiat Oncol Biol Phys 40:897–913PubMedCrossRef

47.

Morris DE (2000) Clinical experience with retreatment for palliation. Semin Radiat Oncol 10:210–221PubMedCrossRef

48.

Langer CJ, Harris J, Horwitz EM et al (2007) Phase II study of low-dose paclitaxel and cisplatin in combination with split-course concomitant twice-daily reirradiation in recurrent squamous cell carcinoma of the head and neck: results of Radiation Therapy Oncology Group Protocol 9911. J Clin Oncol 25:4800–4805PubMedCrossRef

49.

Vermorken JB, Mesia R, Rivera F et al (2008) Platinum-based chemotherapy plus cetuximab in head and neck cancer. N Engl J Med 359:1116–1127PubMedCrossRef

50.

Zwicker F, Roeder F, Thieke C et al (2011) IMRT reirradiation with concurrent cetuximab immunotherapy in recurrent head and neck cancer. Strahlenther Onkol 187:32–38PubMedCrossRef

51.

Balermpas P, Hambek M, Seitz O et al (2009) Combined cetuximab and reirradiation for locoregional recurrent and inoperable squamous cell carcinoma of the head and neck. Strahlenther Onkol 185:775–781PubMedCrossRef

Titel: Re-irradiation combined with capecitabine in locally recurrent squamous cell carcinoma of the head and neck
A prospective phase II trial
verfasst von: L. Vormittag
C. Lemaire
D. Radonjic
G. Kornek
E. Selzer, MD
Publikationsdatum: 01.03.2012
Verlag: Springer-Verlag
Erschienen in: Strahlentherapie und Onkologie / Ausgabe 3/2012
Print ISSN: 0179-7158
Elektronische ISSN: 1439-099X
DOI: https://doi.org/10.1007/s00066-011-0040-9

Neu im Fachgebiet Onkologie

25.04.2024 | Nierenkarzinom | Nachrichten

Springer Medizin

Re-irradiation combined with capecitabine in locally recurrent squamous cell carcinoma of the head and neck

A prospective phase II trial

Abstract

Background

Patients and methods

Results

Conclusion

Neu im Fachgebiet Onkologie

Adjuvante Immuntherapie verlängert Leben bei RCC

Alectinib verbessert krankheitsfreies Überleben bei ALK-positivem NSCLC

Bei Senioren mit Prostatakarzinom auf Anämie achten!

ICI-Therapie in der Schwangerschaft wird gut toleriert

Update Onkologie

Springer Medizin

Abstract

Background

Patients and methods

Results

Conclusion

Bitte loggen Sie sich ein, um Zugang zu diesem Inhalt zu erhalten

Weitere Artikel der Ausgabe 3/2012

Adaptive radiotherapy for soft tissue changes during helical tomotherapy for head and neck cancer

MRT-Screening der Brust nach Bestrahlung der Thoraxwand

Radiation-induced cranial neuropathy in patients with nasopharyngeal carcinoma

High expression of nuclear survivin and Aurora B predicts poor overall survival in patients with head and neck squamous cell cancer

Evidenz für den Einsatz moderner Bestrahlungstechniken beim nicht-kleinzelligen Bronchialkarzinom: unnötig, ungenügend, ausreichend oder zu spät?

The combination of hyperthermia or chemotherapy with gimeracil for effective radiosensitization

Neu im Fachgebiet Onkologie

Adjuvante Immuntherapie verlängert Leben bei RCC

Alectinib verbessert krankheitsfreies Überleben bei ALK-positivem NSCLC

Bei Senioren mit Prostatakarzinom auf Anämie achten!

ICI-Therapie in der Schwangerschaft wird gut toleriert

Update Onkologie