Long-term results of VBM and radiotherapy in advanced head and neck cancer
- 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), Vol. 8:9
- Country of Publication:
- United States
- Language:
- English
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63 RADIATION, THERMAL, AND OTHER ENVIRON. POLLUTANT EFFECTS ON LIVING ORGS. AND BIOL. MAT.
CHEMOTHERAPY
SIDE EFFECTS
EPITHELIUM
BIOLOGICAL RADIATION EFFECTS
RADIOTHERAPY
ALKALOIDS
BLEOMYCIN
HEAD
METHOTREXATE
NECK
PATIENTS
ANIMAL TISSUES
ANTI-INFECTIVE AGENTS
ANTIBIOTICS
ANTIMETABOLITES
ANTIMITOTIC DRUGS
ANTINEOPLASTIC DRUGS
BIOLOGICAL EFFECTS
BODY
BODY AREAS
DRUGS
MEDICINE
NUCLEAR MEDICINE
ORGANIC COMPOUNDS
RADIATION EFFECTS
RADIOLOGY
THERAPY
TISSUES
550603* - Medicine- External Radiation in Therapy- (1980-)
560151 - Radiation Effects on Animals- Man