Combination of cisplatin and radiotherapy in patients with oral cancer
1990 Volume 36 Issue 7 Pages 1776-1789
Details
1990 Volume 36 Issue 7 Pages 1776-1789
Twenty-nine previously untreated patients with carcinoma of the oral cavity, maxillary sinus and oropharynx were treated in a nonrandomized study utilizing combination of cisplatin and radiotherapy.
15 of 29 (51.7%) patients underwent cisplatin induction chemotherapy followed by radiation, the remaining 14 (48.3%) patients received simultaneous administration of cisplatin with radiation.
Treatment and survival results are reported and compared to results obtained in treating 43 historic controls with radiotherapy (RT) alone. All patients in the control group were previously untreated.
The overall major response rate was 82.8% in combined modality group, and 72.1% in RT-alone group. There was no significant difference in response rate between these 2 treatment modalities.
In stage I·II patients, the overall response rate and acutarial 3-years survival was 88.9%, 83.3% in combined modality group, and 96.2%, 82.0% in RT-alone group. There was no statistically significant difference for overall response rate and survival rate between combined modality group and RT-alone group.
In stage III·IV patients, the overall response rate and actuarial 4-years sruvival was 80.0%, 51.9% in combined modality group, and 35.3%, 17.7% in RT-alone group. Combined modality produced a significantly increased response rate and survival in stage II·IV patients compared to patients who received RT-alone.
In the combined modality group, the incidence of secondary regional lymph nodes metastases after completion of the initial treatment was decreased compared to those seen in RTalone group. Our results suggests that the use of cisplatin induction chemotherapy prior to radiation improves the complete response rate compared to that seen in simultaneous administration of cisplatin with radiation.
Most significant toxicity was the gastrointestinal toxicity, nausea, vomiting and mucositis. In general, toxicity was tolerable and reversible.
In conclusion, the combination of cisplatin and radiotherapy appears to be associated with a higher response rate and prolonged survival compared to radiotherapy alone.
