skip to main content
OSTI.GOV title logo U.S. Department of Energy
Office of Scientific and Technical Information

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

Abstract

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/m{sup 2}) and cisplatin (50 mg/m{sup 2}) Weeks 1, 3, and 5 concurrently with RT (72 Gy, 42 fractions over 6 weeks). TPZ (160 mg/m{sup 2}) 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 ofmore » 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.« less

Authors:
 [1];  [2];  [3];  [4];  [5];  [5];  [2];  [6];  [4];  [4];  [2]
  1. Section of Hematology/Oncology, Department of Medicine, University of Chicago, Chicago, IL (United States) and University of Chicago Cancer Research Center, Chicago, IL (United States). E-mail: ecohen@medicine.bsd.uchicago.edu
  2. Institut Gustave Roussy, Villejuif (France)
  3. University of Chicago Cancer Research Center, Chicago, IL (United States)
  4. (United States)
  5. Sanofi-Synthelabo Research, Malvern, PA (United States)
  6. Section of Hematology/Oncology, Department of Medicine, University of Chicago, Chicago, IL (United States)
Publication Date:
OSTI Identifier:
20944716
Resource Type:
Journal Article
Resource Relation:
Journal Name: International Journal of Radiation Oncology, Biology and Physics; Journal Volume: 67; Journal Issue: 3; Other Information: DOI: 10.1016/j.ijrobp.2006.09.056; PII: S0360-3016(06)03371-2; Copyright (c) 2007 Elsevier Science B.V., Amsterdam, Netherlands, All rights reserved; Country of input: International Atomic Energy Agency (IAEA)
Country of Publication:
United States
Language:
English
Subject:
62 RADIOLOGY AND NUCLEAR MEDICINE; CARCINOMAS; CAROTID ARTERIES; CHEMOTHERAPY; DERMATITIS; HEAD; NECK; PATIENTS; PNEUMONIA; RADIATION DOSES; RADIOTHERAPY; RUPTURES; SENSITIZERS; TOXICITY

Citation Formats

Cohen, Ezra E.W., Rosine, Dominique, Haraf, Daniel J., Department of Radiation and Cellular Oncology, University of Chicago, Chicago, IL, Loh, Elwyn, Shen, Liji, Lusinchi, Antoine, Vokes, Everett E., University of Chicago Cancer Research Center, Chicago, IL, Department of Radiation and Cellular Oncology, University of Chicago, Chicago, IL, and Bourhis, Jean. Phase I trial of tirapazamine, cisplatin, and concurrent accelerated boost reirradiation in patients with recurrent head and neck cancer. United States: N. p., 2007. Web. doi:10.1016/j.ijrobp.2006.09.056.
Cohen, Ezra E.W., Rosine, Dominique, Haraf, Daniel J., Department of Radiation and Cellular Oncology, University of Chicago, Chicago, IL, Loh, Elwyn, Shen, Liji, Lusinchi, Antoine, Vokes, Everett E., University of Chicago Cancer Research Center, Chicago, IL, Department of Radiation and Cellular Oncology, University of Chicago, Chicago, IL, & Bourhis, Jean. Phase I trial of tirapazamine, cisplatin, and concurrent accelerated boost reirradiation in patients with recurrent head and neck cancer. United States. doi:10.1016/j.ijrobp.2006.09.056.
Cohen, Ezra E.W., Rosine, Dominique, Haraf, Daniel J., Department of Radiation and Cellular Oncology, University of Chicago, Chicago, IL, Loh, Elwyn, Shen, Liji, Lusinchi, Antoine, Vokes, Everett E., University of Chicago Cancer Research Center, Chicago, IL, Department of Radiation and Cellular Oncology, University of Chicago, Chicago, IL, and Bourhis, Jean. Thu . "Phase I trial of tirapazamine, cisplatin, and concurrent accelerated boost reirradiation in patients with recurrent head and neck cancer". United States. doi:10.1016/j.ijrobp.2006.09.056.
@article{osti_20944716,
title = {Phase I trial of tirapazamine, cisplatin, and concurrent accelerated boost reirradiation in patients with recurrent head and neck cancer},
author = {Cohen, Ezra E.W. and Rosine, Dominique and Haraf, Daniel J. and Department of Radiation and Cellular Oncology, University of Chicago, Chicago, IL and Loh, Elwyn and Shen, Liji and Lusinchi, Antoine and Vokes, Everett E. and University of Chicago Cancer Research Center, Chicago, IL and Department of Radiation and Cellular Oncology, University of Chicago, Chicago, IL and Bourhis, Jean},
abstractNote = {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/m{sup 2}) and cisplatin (50 mg/m{sup 2}) Weeks 1, 3, and 5 concurrently with RT (72 Gy, 42 fractions over 6 weeks). TPZ (160 mg/m{sup 2}) 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.},
doi = {10.1016/j.ijrobp.2006.09.056},
journal = {International Journal of Radiation Oncology, Biology and Physics},
number = 3,
volume = 67,
place = {United States},
year = {Thu Mar 01 00:00:00 EST 2007},
month = {Thu Mar 01 00:00:00 EST 2007}
}