Long-term results of VBM and radiotherapy in advanced head and neck cancer

Journal Article · Wed Sep 01 04:00:00 EDT 1982 · Int. J. Radiat. Oncol., Biol. Phys.; (United States)

DOI:https://doi.org/10.1016/0360-3016(82)90612-5· OSTI ID:6579533

O'Conner, D ^[1]; Clifford, P; Edwards, W G; Dalley, V M; Durden-Smith, J; Hollis, B A; Calman, F M

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1. Kings Coll. Hospital, London, England

A report of a prospective pilot study is presented of 198 patients with advanced head and neck cancer, Stage III and IV, treated over 7 years with a combination of radical radiotherapy and a multidrug cytotoxic regimen, VBM (Vincristine, Bleomycin and Methotrexate) given synchronously during radiotherapy. All patients considered had disease classified as follows: T1 or T2 with clinically positive nodes (N+) and T3 or T4, irrespective of nodal status (N') were acceptable. Radiotherapy was divided into three equal sub-courses. The total dose aimed at was 60-66 Gy (1.8-2 Gy fractions daily).Usually three or four courses of VBM were given, one before the first sub-course of radiotherapy and the others immediately after each sub-course. The intervals allowed between each sub-course of radiation produced a median reduction over all patients of 4.5% in TDF (ret NSD) below the standard course of 30 x 20 Gy in 6 weeks. Survival and recurrence-free data were fully documented. The crude actuarial survival probability was 41% at 60 months (198 patients). The probability of remaining totally recurrence-free (disease-free deaths excluded) was 52% at 60 months. The presence of N+ disease affected adversely both survival and non-recurrence, 30% vs 61% and 46% vs 67%, respectively, at 30 months. Reduced survival was in part a result of an increased number of treatment-related deaths and metastases in N+ disease. Maintained local remission of disease above the clavicle was observed in 122/198 patients (62%). Salvage surgery was performed in 28/76 patients and 11 were rendered free of local disease during follow-up. This prospective pilot study shows results which are an improvement on our previous experience with radiotherapy and surgery alone and on the disease control generally reported.

• OSTI ID: 6579533
• Journal Information: Int. J. Radiat. Oncol., Biol. Phys.; (United States), Journal Name: Int. J. Radiat. Oncol., Biol. Phys.; (United States) Vol. 8:9; 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.
ALKALOIDS
ANIMAL TISSUES
ANTI-INFECTIVE AGENTS
ANTIBIOTICS
ANTIMETABOLITES
ANTIMITOTIC DRUGS
ANTINEOPLASTIC DRUGS
BIOLOGICAL EFFECTS
BIOLOGICAL RADIATION EFFECTS
BLEOMYCIN
BODY
BODY AREAS
CHEMOTHERAPY
DRUGS
EPITHELIUM
HEAD
MEDICINE
METHOTREXATE
NECK
NUCLEAR MEDICINE
ORGANIC COMPOUNDS
PATIENTS
RADIATION EFFECTS
RADIOLOGY
RADIOTHERAPY
SIDE EFFECTS
THERAPY
TISSUES