Alternating chemo-radiotherapy with cisplatin and 5-fluorouracil plus bleomycin by continuous infusion for locally advanced undifferentiated carcinoma nasopharyngeal type
Identifieur interne : 000455 ( France/Analysis ); précédent : 000454; suivant : 000456Alternating chemo-radiotherapy with cisplatin and 5-fluorouracil plus bleomycin by continuous infusion for locally advanced undifferentiated carcinoma nasopharyngeal type
Auteurs : N. Azli [Algérie] ; J. P Armand [France] ; M. Rahal [Algérie] ; P. Wibault [France] ; H. Boussen [Tunisie] ; F. Eschwege [France] ; G. Schwaab [France] ; J. Gasmi [France] ; M. Bachouchi [France] ; E. Cvitkovic [France]Source :
- European Journal of Cancer [ 0959-8049 ] ; 1992.
Abstract
More than 80% of undifferentiated carcinoma nasopharyngeal type patients with N3 disease (AJC-UICC 1987) will die with or from distant metastases within 3 years after the first symptom. From February 1986 to November 1987 30 consecutive patients with very advanced local disease were entered in a programme with chemotherapy-radiotherapy (CT-RT) alternation after a thorough work-up to eliminate the possibility of distant metastases. Protocol: two cycles of cisplatin 100 mg/m2 day 1, bleomycin 15 mg intravenously day 1 and 16 mg/m2 per day by continuous infusion days 1–5; 5-fluorouracil (5-FU) 650 mg/m2 per day by continuous infusion days 1–5 4 weeks apart. This was followed by two series of high-energy radiotherapy, 35 Gy/3.5 weeks, with a third chemotherapy cycle in between. 27 men and 3 women were treated, the median age was 37 years (range 17–71) and the mean WHO performance status was 1 (range 0–3). TNM classification: 15 T4, 9 T3, 6 T2, 28 N3 and 2 N2c. 18 patients had nodes larger than 8 cm and 24 had bulky bilateral cervical nodes. Toxicity for this protocol was moderate, nausea and vomiting being the main side-effects. Results after two CT cycles were 3 complete responses (CR; 10%), 22 partial responses (PR; 73%), 2 disease stabilisations, 2 progressions, and 1 patient inevaluable. Of the 30 patients, 27 patients completed the CT-RT protocol, 2 patients died before radiotherapy and 1 refused treatment after 2 days on protocol. 25 patients were in CR 3 months after the end of radiotherapy. As of August 1991, with a median follow-up of 55 months (range 43–63), there are 17 patients alive, 2 of them with active disease and 15 are NED (2 after salvage therapy).
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DOI: 10.1016/0959-8049(92)90005-M
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From February 1986 to November 1987 30 consecutive patients with very advanced local disease were entered in a programme with chemotherapy-radiotherapy (CT-RT) alternation after a thorough work-up to eliminate the possibility of distant metastases. Protocol: two cycles of cisplatin 100 mg/m2 day 1, bleomycin 15 mg intravenously day 1 and 16 mg/m2 per day by continuous infusion days 1–5; 5-fluorouracil (5-FU) 650 mg/m2 per day by continuous infusion days 1–5 4 weeks apart. This was followed by two series of high-energy radiotherapy, 35 Gy/3.5 weeks, with a third chemotherapy cycle in between. 27 men and 3 women were treated, the median age was 37 years (range 17–71) and the mean WHO performance status was 1 (range 0–3). TNM classification: 15 T4, 9 T3, 6 T2, 28 N3 and 2 N2c. 18 patients had nodes larger than 8 cm and 24 had bulky bilateral cervical nodes. Toxicity for this protocol was moderate, nausea and vomiting being the main side-effects. Results after two CT cycles were 3 complete responses (CR; 10%), 22 partial responses (PR; 73%), 2 disease stabilisations, 2 progressions, and 1 patient inevaluable. Of the 30 patients, 27 patients completed the CT-RT protocol, 2 patients died before radiotherapy and 1 refused treatment after 2 days on protocol. 25 patients were in CR 3 months after the end of radiotherapy. As of August 1991, with a median follow-up of 55 months (range 43–63), there are 17 patients alive, 2 of them with active disease and 15 are NED (2 after salvage therapy).</div></front></TEI><affiliations><list><country><li>Algérie</li><li>France</li><li>Tunisie</li></country><region><li>Gouvernorat de Tunis</li></region><settlement><li>Tunis</li></settlement></list><tree><country name="Algérie"><noRegion><name sortKey="Azli, N" sort="Azli, N" uniqKey="Azli N" first="N" last="Azli">N. Azli</name></noRegion><name sortKey="Rahal, M" sort="Rahal, M" uniqKey="Rahal M" first="M" last="Rahal">M. Rahal</name></country><country name="France"><noRegion><name sortKey="Armand, J P" sort="Armand, J P" uniqKey="Armand J" first="J. P" last="Armand">J. P Armand</name></noRegion><name sortKey="Bachouchi, M" sort="Bachouchi, M" uniqKey="Bachouchi M" first="M" last="Bachouchi">M. Bachouchi</name><name sortKey="Cvitkovic, E" sort="Cvitkovic, E" uniqKey="Cvitkovic E" first="E" last="Cvitkovic">E. Cvitkovic</name><name sortKey="Eschwege, F" sort="Eschwege, F" uniqKey="Eschwege F" first="F" last="Eschwege">F. Eschwege</name><name sortKey="Gasmi, J" sort="Gasmi, J" uniqKey="Gasmi J" first="J" last="Gasmi">J. Gasmi</name><name sortKey="Schwaab, G" sort="Schwaab, G" uniqKey="Schwaab G" first="G" last="Schwaab">G. Schwaab</name><name sortKey="Wibault, P" sort="Wibault, P" uniqKey="Wibault P" first="P" last="Wibault">P. Wibault</name></country><country name="Tunisie"><region name="Gouvernorat de Tunis"><name sortKey="Boussen, H" sort="Boussen, H" uniqKey="Boussen H" first="H" last="Boussen">H. 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