Treatment complications after sequential combination chemotherapy and radiotherapy with or without surgery in previously untreated squamous cell carcinoma of the head and neck

Journal Article · Fri Nov 01 04:00:00 EST 1985 · Int. J. Radiat. Oncol., Biol. Phys.; (United States)

DOI:https://doi.org/10.1016/0360-3016(85)90268-8· OSTI ID:6293044

Posner, M R; Weichselbaum, R R; Fitzgerald, T J; Clark, J R; Rose, C; Fabian, R L; Norris, Jr, C M; Miller, D; Tuttle, S A; Ervin, T J

One hundred consecutive patients with previously untreated advanced squamous cell carcinoma of the head and neck were treated with induction combination chemotherapy followed by definitive surgery and/or radiotherapy, and were evaluated for radiotherapy related toxicity. The induction regimen consisted of cisplatin, bleomycin and methotrexate/leucovorin. Acute toxicity consisted predominantly of mucositis and weight loss, and was mild or moderate by degree in 94% of patients. Six percent of patients experienced severe or life threatening acute toxicities. Two acute toxic deaths were noted in this series, one from a combination of mucositis, weight loss and infection and one from hypoglycemia of unknown origin. Thirty-five percent of patients had radiation treatment interrupted briefly because of acute toxicity. Radiotherapy dose, surgical intervention and age did not have an impact on the presence or degree of acute toxicity. Late toxicities included: hypothyroidism in 32% of patients tested: osteoradionecrosis in 5% of patients, associated primarily with a composite resection (4 of 5 cases); and soft tissue ulcerations in 3%. Taken together, these data indicate that induction combination chemotherapy did not significantly increase the toxicity of subsequent radiotherapy with or without surgery.

• Research Organization: Dana-Farber Cancer Institute, Boston, MA
• OSTI ID: 6293044
• Journal Information: Int. J. Radiat. Oncol., Biol. Phys.; (United States), Journal Name: Int. J. Radiat. Oncol., Biol. Phys.; (United States) Vol. 11; ISSN IOBPD
• Country of Publication: United States
• Language: English

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62 RADIOLOGY AND NUCLEAR MEDICINE
63 RADIATION, THERMAL, AND OTHER ENVIRON. POLLUTANT EFFECTS ON LIVING ORGS. AND BIOL. MAT.
ANTIMETABOLITES
BIOLOGICAL EFFECTS
BIOLOGICAL RADIATION EFFECTS
BODY
BODY AREAS
CARCINOMAS
CHEMOTHERAPY
CITROVORUM FACTOR
DISEASES
DRUGS
ENDOCRINE DISEASES
HEAD
HYPOTHYROIDISM
INFECTIOUS DISEASES
INJURIES
LOCAL RADIATION EFFECTS
MEDICINE
MEMBRANES
METHOTREXATE
MUCOUS MEMBRANES
NECK
NECROSIS
NEOPLASMS
NUCLEAR MEDICINE
OSTEORADIONECROSIS
PATHOLOGICAL CHANGES
PNEUMONIA
RADIATION EFFECTS
RADIATION INJURIES
RADIOINDUCTION
RADIOLOGY
RADIOTHERAPY
RESPIRATORY SYSTEM DISEASES
SIDE EFFECTS
SKELETAL DISEASES
THERAPY
ULCERS