Concurrent chemoradiotherapy using cisplatin, tegafur, and leucovorin for advanced squamous cell carcinoma of the hypopharynx and oropharynx

• Main Authors: Hung-Ming Wang, Cheng-Lung Hsu, Chia-Hsun Hsieh, Kang-Hsing Fan, Chien-Yu Lin, Joseph Tung-Chieh Chang, Shiang-Fu Huang, I-How Chen, Chun-Ta Liao, Shu-Kung Ng
• Format: Article
• Language: English
• Published: Elsevier 2014-06-01
• Series: Biomedical Journal
• Subjects: chemoradiotherapy; chemotherapy; head and neck cancer; leucoverin; radiotherapy; tegafur
• Online Access: http://www.biomedj.org/article.asp?issn=2319-4170;year=2014;volume=37;issue=3;spage=133;epage=140;aulast=Wang
• ISSN: 2319-4170; 2320-2890

Background: To evaluate the efficacy and adverse events of cisplatin, tegafur, and leucovorin concomitantly with radiotherapy for patients with advanced, non-metastatic squamous cell carcinoma (SCC) of the oropharynx and hypopharynx. Methods: The PTL regimen consisted of cisplatin (P) 50 mg/m 2 on day 1, oral tegafur (T) 800 mg/day plus leucovorin (LV) 60 mg/day on days 1 through 14. It was repeated every 2 weeks through the radiotherapy course. Conventional radiotherapy with 1.8-2.0 Gy/day, 5 days per week, was delivered in a total dose of between 70 and 72 Gy. Results: Sixty-five patients with stage III or IV of SCC of the head and neck were consecutively treated between May 2002 and November 2005. Forty-six (70.7%) patients had complete response after concomitant chemoradiotherapy (CCRT). With a median follow-up of 54.0 months (range 1-103 months), the 5-year locoregional control, progression-free survival, and overall survival rates were 50.6%, 40.7%, and 59.7%, respectively. Three (4.6%) patients had toxic death during treatment. Fifty-one (80.0%) patients experienced grade 3-4 mucositis which occurred in about 35% of the CCRT duration. The functional preservation rate among post-CCRT complete responders was 93.5% (43/46). The median cisplatin accumulated dosage was 150 mg, and the rate of hearing impairment among the survivors was 7.8%. Conclusion: CCRT with outpatient-based PTL for advanced SCC of oropharynx and hypopharynx is feasible and has comparative efficacy and acceptable adverse events.