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Neurotoxicity in a phase I trial of continuous-infusion cisplatin with hyperfractionated radiotherapy for locally advanced head and neck cancer

1996; Wiley; Volume: 18; Issue: 3 Linguagem: Inglês

10.1002/(sici)1097-0347(199605/06)18

1097-0347

Gerald H. Clamon, Lynn Baatz, Henry T. Hoffman, David H. Hussey, Matthew Glascock, Timothy M. McCulloch, Scott M. Graham,

Lung Cancer Research Studies

Head & NeckVolume 18, Issue 3 p. 236-241 Neurotoxicity in a phase I trial of continuous-infusion cisplatin with hyperfractionated radiotherapy for locally advanced head and neck cancer Gerald H. Clamon MD, Corresponding Author Gerald H. Clamon MD Departments of Internal Medicine, Otolaryngology, and Radiation Oncology, University of Iowa College of Medicine, Iowa City, IowaUniversity of Iowa Hospitals and Clinics, Department of Internal Medicine, 200 Hawkins Drive, Iowa City, IA 52242Search for more papers by this authorLynn Baatz MD, Lynn Baatz MD Departments of Internal Medicine, Otolaryngology, and Radiation Oncology, University of Iowa College of Medicine, Iowa City, IowaSearch for more papers by this authorHenry T. Hoffman MD, Henry T. Hoffman MD Departments of Internal Medicine, Otolaryngology, and Radiation Oncology, University of Iowa College of Medicine, Iowa City, IowaSearch for more papers by this authorDavid H. Hussey MD, David H. Hussey MD Departments of Internal Medicine, Otolaryngology, and Radiation Oncology, University of Iowa College of Medicine, Iowa City, IowaSearch for more papers by this authorMatthew Glascock MD, Matthew Glascock MD Departments of Internal Medicine, Otolaryngology, and Radiation Oncology, University of Iowa College of Medicine, Iowa City, IowaSearch for more papers by this authorTimothy M. McCulloch MD, Timothy M. McCulloch MD Departments of Internal Medicine, Otolaryngology, and Radiation Oncology, University of Iowa College of Medicine, Iowa City, IowaSearch for more papers by this authorScott M. Graham MD, Scott M. Graham MD Departments of Internal Medicine, Otolaryngology, and Radiation Oncology, University of Iowa College of Medicine, Iowa City, IowaSearch for more papers by this author Gerald H. Clamon MD, Corresponding Author Gerald H. Clamon MD Departments of Internal Medicine, Otolaryngology, and Radiation Oncology, University of Iowa College of Medicine, Iowa City, IowaUniversity of Iowa Hospitals and Clinics, Department of Internal Medicine, 200 Hawkins Drive, Iowa City, IA 52242Search for more papers by this authorLynn Baatz MD, Lynn Baatz MD Departments of Internal Medicine, Otolaryngology, and Radiation Oncology, University of Iowa College of Medicine, Iowa City, IowaSearch for more papers by this authorHenry T. Hoffman MD, Henry T. Hoffman MD Departments of Internal Medicine, Otolaryngology, and Radiation Oncology, University of Iowa College of Medicine, Iowa City, IowaSearch for more papers by this authorDavid H. Hussey MD, David H. Hussey MD Departments of Internal Medicine, Otolaryngology, and Radiation Oncology, University of Iowa College of Medicine, Iowa City, IowaSearch for more papers by this authorMatthew Glascock MD, Matthew Glascock MD Departments of Internal Medicine, Otolaryngology, and Radiation Oncology, University of Iowa College of Medicine, Iowa City, IowaSearch for more papers by this authorTimothy M. McCulloch MD, Timothy M. McCulloch MD Departments of Internal Medicine, Otolaryngology, and Radiation Oncology, University of Iowa College of Medicine, Iowa City, IowaSearch for more papers by this authorScott M. Graham MD, Scott M. Graham MD Departments of Internal Medicine, Otolaryngology, and Radiation Oncology, University of Iowa College of Medicine, Iowa City, IowaSearch for more papers by this author First published: May/June 1996 https://doi.org/10.1002/(SICI)1097-0347(199605/06)18:3 3.0.CO;2-0Citations: 9AboutPDF ToolsRequest permissionExport citationAdd to favoritesTrack citation ShareShare Give accessShare full text accessShare full-text accessPlease review our Terms and Conditions of Use and check box below to share full-text version of article.I have read and accept the Wiley Online Library Terms and Conditions of UseShareable LinkUse the link below to share a full-text version of this article with your friends and colleagues. Learn more.Copy URL Abstract Background Both twice daily fractionated radiotherapy and concurrent cisplatin with once-daily radiotherapy have been shown to improve local disease control in patients with head and neck cancer. The objective of this phase I trial was to determine the maximum tolerated dose of cisplatin which could be given as a continuous infusion concurrent with twice-daily radiotherapy to patients with locally advanced head and neck cancer. Methods Patients were treated with radiotherapy at doses of 110 cGy twice daily for 5 days per week to a total dose of 7040–7590 cGy. Concurrent with radiotherapy, patients received continuous-infusion cisplatin for 5 days per week. Groups of 3–6 patients were treated with doses of 1–3 mg/m2/day. Results Central nervous system toxicity became dose-limiting. At 1 mg/m2, 2 mg/m2, and 3 mg/m2 confusion was observed and one patient had a seizure. At 3 mg/m2, another patient suffered severe sensory and motor neuropathy. Despite bulky tumors, 12 of the 14 patients had an objective response and 3 achieved a complete response. Conclusions The combination of twice-daily fractionated radiotherapy and concurrent cisplatin by continuous infusion is severely toxic and achieves results similar to less toxic programs. It is not recommended for further investigation or therapy. © 1996 John Wiley & Sons, Inc. Citing Literature Volume18, Issue3May/June 1996Pages 236-241 RelatedInformation