Numerous treatment concepts for advanced but resectable oral and oropharyngeal squamous cell carcinoma exist. In this study, we present the 7-year results of a promising treatment with preoperative simultaneous chemoradiation using paclitaxel and carboplatin within a prospective phase II trial comprising 56 patients. After determination of the local tumor extension, chemoradiation was applied for 4 weeks and up to 40 Gy. Following a recovery period of 3–4 weeks, tumor resection was performed within the initially tattooed resection margins, together with a functional modified neck dissection. The median follow-up time was 44.9 ± 19.6 months (range 0.76–87.9). After 7 years, 35 (63.3%) patients were alive and 20 (36.4%) had died. In 2 patients (3.6%), the cause of death was related to treatment. After 7 years, the overall survival rate declined to 63.6%, whereas the local recurrence-free probability was still 84.2%. These results confirm the excellent local control and high survival rates of preoperative radiochemotherapy with the combination of paclitaxel/carboplatin.

1.
Kirita T, Ohgi K, Shimooka H, Yamanaka Y, Tatebayashi S, Yamamoto K, Mishima K, Sugimura M: Preoperative concurrent chemoradiotherapy plus radical surgery for advanced squamous cell carcinoma of the oral cavity: an analysis of long-term results. Oral Oncol 1999;35:597–606.
2.
Mohr C, Bohndorf W, Carstens J, Härle F, Hausamen JE, Hirche H, Kimmig H, Kutzner J, Mühling J, Reuther J, et al: Preoperative radiochemotherapy and radical surgery in comparison with radical surgery alone. A prospective, multicentric, randomized DOSAK study of advanced squamous cell carcinoma of the oral cavity and the oropharynx (a 3-year follow-up). Int J Oral Maxillofac Surg 1994;23:140–148.
3.
Pignon JP, Bourhis J, Domenge C, Désigné L: Chemotherapy added to locoregional treatment for head and neck squamous cell carcinoma: three meta-analyses of updated individual data. Lancet 2000;355:949–955.
4.
Adelstein D, Lavertu P, Saxton JP, et al: Mature results of phase III randomized trial comparing concurrent chemoradiotherapy with radiation therapy alone in patients with stage III and IV squamous cell carcinoma of the head and neck. Cancer 2000;88:876–883.
5.
Wendt TG, Hartenstein RC, Wustrow TPU, Lissner J: Cisplatin, 5-FU with folinic acid enhancement and synchronous accelerated radiotherapy in the management of locally advanced head and neck cancer: a phase II study. J Clin Oncol 1989;7:471–476.
6.
Wendt TG: Radiochemotherapie bei fortgeschrittenen Kopf-Hals-Karzinomen – was ist gesichert? Strahlenther Onkol 1996;172:409–416.
7.
Zamboglou N, Schnabel T, Kolotas C, Achterrath W, Strehl H, Dahlhauser S, Vogt HG, Lenaz L, Schmitt G: Carboplatin and radiotherapy in the treatment of head and neck cancer: six years’ experience. Semin Oncol 1994;21(suppl 12):45–53.
8.
Bartsch V: Das Taxol®-Buch. Stuttgart, Georg Thieme, 2000.
9.
Huang GC, Liu SY, Lin MH, Kuo YY, Liu YC: The synergistic cytotoxicity of cisplatin and taxol in killing oral squamous cell carcinoma. Jpn J Clin Oncol 2004;34:499–504.
10.
Choy H, Browne MJ: Paclitaxel as radiation sensitizer in non-small-cell lung cancer. Semin Oncol 1995;22(suppl 6):70–74.
11.
Conley B, Jacobs M, Suntharalingam M, et al: A pilot study of paclitaxel, carboplatin and concurrent radiotherapy for unresectable squamous cell carcinoma of the head and neck. Semin Oncol 1997;24(suppl 2):78–80.
12.
Eckardt A, Wildfang I, Rades D, Kuettner C, Dammer R, Hofele C, Karstens JH: Multicenter phase II study of preoperative concurrent paclitaxel, carboplatin and radiotherapy in stage III/IV resectable cancer of the oropharynx and oral cavity: an interim analysis (abstract 1658). Proc Am Soc Clin Oncol 2000;19:420a.
13.
Chougule P, Wanebo H, Akhtar M, et al: Concurrent paclitaxel, carboplatin and radiotherapy in advanced head and neck cancers: a phase II study (abstract 1468). Proc Am Soc Clin Oncol 1998;17:381a.
14.
Oken MM, Creech RH, Tormey DC, Horton J, Davis TE, McFadden ET, Carbone PP: Toxicity and response criteria of the Eastern Cooperative Oncology Group. Am J Clin Oncol 1982;5:649–655.
15.
Forastiere AA, Trotti A: Radiotherapy and concurrent chemotherapy: a strategy that improves locoregional control and survival in oropharyngeal cancer. J Nat Cancer Inst 1999;91:2065–2066.
16.
Cohen EEW, Lingen MW, Vokes EE: The expanding role of systemic therapy in head and neck cancer. J Clin Oncol 2004;22:1743–1752.
17.
Harari PM: Promising new advances in head and neck radiotherapy. Ann Oncol 2005;16(suppl 6):vi13–vi19.
18.
Browmann GP, Hodson DI, Mackenzie RJ, et al: Choosing a concomitant chemotherapy and radiotherapy regimen for squamous cell head and neck cancer: a systematic review of the published literature with subgroup analysis. Head Neck 2001;23:579–589.
19.
El-Sayed S, Nelson N: Adjuvant and adjunctive chemotherapy in the management of squamous cell carcinoma of the head and neck region. A meta-analysis of prospective and randomized trials. J Clin Oncol 1996;14:838–847.
20.
Munro AJ: An overview of randomized controlled trials in adjuvant chemotherapy in head and neck cancer. Brit J Cancer 1995;71:83–91.
21.
Becker A, Buechele T, Sandner A, Haensgen G, Schoeber C, Mir-Salim P, Berghaus A, Dunst J, Schmoll HJ: Reirradiation of squamous cell carcinomas of the head and neck (SCCHN) combined with simultaneous paclitaxel (PAC) in a twice-a-week schedule (results of a phase I/II study) (abstract 1551). Proc Am Soc Clin Oncol 1998;17:402a.
22.
Plasswilm L, Kirchner M, Sauer R: Concurrent paclitaxel and split-course accelerated radiotherapy for advanced head and neck cancer. Strahlenther Onkol 1996;10:173–179.
23.
Eckardt A, Rades D, Rudat V, Hofele C, Dammer R, Dietl B, Wildfang I, Karstens JH: Prospektive Phase-II-Studie zur neoadjuvanten Radiochemotherapie fortgeschrittener, operabler Mundhöhlenkarzinome. 3-Jahres-Ergebnisse. Mund Kiefer Gesichts Chir 2002;6:117–121.
24.
Airoldi M, Cortesina G, Giordano C, Pedani F, Bumma C: Ifosfamide in the treatment of head and neck cancer. Oncology 2003;65(suppl 2):37–43.
25.
Shin DM, Glisson BS, Khuri FR, et al: Phase II study of induction chemotherapy with paclitaxel, ifosfamide, and carboplatin (TIC) for patients with locally advanced squamous cell carcinoma of the head and neck. Cancer 2002;95:322–330.
26.
Klug C, Wutzl A, Kermer C, et al: Preoperative radiochemotherapy and radical resection for stages II–IV oral and oropharyngeal cancer: outcome of 222 patients. Int J Oral Maxillofac Surg 2005;34:143–148.
27.
Dunphy FR, Dunleavy TL, Harrison BR, Trinkaus KN, Kim HJ, Stack BC, Needles B, Boyd JH: Induction paclitaxel and carboplatin for patients with head and neck carcinoma. Analysis of 62 patients treated between 1994 and 1999. Cancer 2001;91:940–948.
28.
Sunwoo JB, Herscher LL, Kroog GS, Thomas GR, Ondrey FG, Duffey DC, Solomon BI, Boss C, Albert PS, McCullugh L, Rudy S, Muir C, Zhai S, Figg WD, Cook JA, Mitchell JB, Van Waes C: Concurrent paclitaxel and radiation in the treatment of locally advanced head and neck cancer. J Clin Oncol 2001;19:800–811.
29.
Wanebo HJ, Chougule P, Ready N, Koness RJ, Akerley W, McRae R, Nigri P, Leone L, Webber B, Safran H: Preoperative paclitaxel, carboplatin and radiation therapy in advanced head and neck cancer (stage III and IV). Semin Radiat Oncol 1999;9(suppl 1):77–84.
30.
Dobrowsky W, Dobrowsky E, Strassl H, Braun O, Gritzmann N, Scheiber V: Combined modality treatment of advanced cancers of the oral cavity and oropharynx. Int J Radiat Oncol Biol Phys 1991;20:239–242.
31.
Brizel DM, Leopold KA, Fisher SR, Panella TJ, Fine RL, Bedosian CL, Kenan PD, Huang A, Womack T, Bjurstom T, Dodge R, Prosnitz LR: A phase I/II trial of twice daily irradiation and concurrent chemotherapy for locally advanced squamous cell carcinoma of the head and neck. Int J Radiat Oncol Biol Phys 1994;28:213–220.
32.
Weissler MC, Melin S, Sailer SL, Qaqish BF, Rosemann JG, Pillsbury HC: Simultaneous chemoradiation in the treatment of advanced head and neck cancer. Arch Otolaryngol Head Neck Surg 1992;118:806–810.
33.
Wanebo H, Chourge P, Ready N, Safran H, Ackerly W, Koness RJ, McRae R, Nigri P, Leone L, Radie-Keane K, Reiss P, Kennedy T: Surgical resection is necessary to maximize tumor control in function-preserving, aggressive chemoradiation protocols for advanced cancer of the head and neck (stage III and IV). Ann Surg Oncol 2001;8:644–650.
Copyright / Drug Dosage / Disclaimer
Copyright: All rights reserved. No part of this publication may be translated into other languages, reproduced or utilized in any form or by any means, electronic or mechanical, including photocopying, recording, microcopying, or by any information storage and retrieval system, without permission in writing from the publisher.
Drug Dosage: The authors and the publisher have exerted every effort to ensure that drug selection and dosage set forth in this text are in accord with current recommendations and practice at the time of publication. However, in view of ongoing research, changes in government regulations, and the constant flow of information relating to drug therapy and drug reactions, the reader is urged to check the package insert for each drug for any changes in indications and dosage and for added warnings and precautions. This is particularly important when the recommended agent is a new and/or infrequently employed drug.
Disclaimer: The statements, opinions and data contained in this publication are solely those of the individual authors and contributors and not of the publishers and the editor(s). The appearance of advertisements or/and product references in the publication is not a warranty, endorsement, or approval of the products or services advertised or of their effectiveness, quality or safety. The publisher and the editor(s) disclaim responsibility for any injury to persons or property resulting from any ideas, methods, instructions or products referred to in the content or advertisements.
You do not currently have access to this content.