Neoadjuvant Carboplatin and Vinorelbine Followed by Chemoradiotherapy in Locally Advanced Head and Neck or Oesophageal Squamous Cell Carcinoma: A Phase II Study in Elderly Patients or Patients with Poor Performance Status

• Published in: Anticancer research Vol. 28; no. 2B; pp. 1383 - 1388
• Main Authors: KOUSSIS, Haralabos, SCOLA, Annamaria, LORA, Ornella, BOTTIN, Raffaele, MARIONI, Gino, DONACH, Martin, JIRILLO, Antonio, BERGAMO, Francesca, TONELLO, Stefano, BASSO, Umberto, KARAHONTZITIS, Paraskevi, CHIARION-SILENI, Vanna, PASETTO, Lara, RUOL, Alberto, LOREGGIAN, Lucio
• Format: Journal Article
• Language: English
• Published: Attiki International Institute of Anticancer Research 01-03-2008
• Subjects: Adult; Aged; Aged, 80 and over; Antineoplastic Combined Chemotherapy Protocols - adverse effects; Antineoplastic Combined Chemotherapy Protocols - therapeutic use; Biological and medical sciences; Carboplatin - administration & dosage; Carboplatin - adverse effects; Carcinoma, Squamous Cell - drug therapy; Carcinoma, Squamous Cell - pathology; Carcinoma, Squamous Cell - radiotherapy; Esophageal Neoplasms - drug therapy; Esophageal Neoplasms - pathology; Esophageal Neoplasms - radiotherapy; Esophagus; Female; Gastroenterology. Liver. Pancreas. Abdomen; Head and Neck Neoplasms - drug therapy; Head and Neck Neoplasms - pathology; Head and Neck Neoplasms - radiotherapy; Humans; Male; Medical sciences; Middle Aged; Neoadjuvant Therapy; Neoplasm Staging; Survival Rate; Tumors; Vinblastine - administration & dosage; Vinblastine - adverse effects; Vinblastine - analogs & derivatives; Antineoplastic agent; Performance evaluation; Esophageal disease; Esophagus squamous cell carcinoma; Chemoradiotherapy; Esophagus cancer; Neoadjuvant treatment; oesophageal cancer; Alkaloid; Cancerology; Phase II trial; Head and neck; ENT disease; Antimitotic; Platinum II Complexes; Human; Malignant tumor; poor performance status; Carboplatin; Digestive diseases; Head and neck cancer; Locally advanced stage; Elderly; Vinorelbine; Cancer
• ISSN: 0250-7005; 1791-7530

Background: The purpose of this study was to evaluate the efficacy and toxicity of neo-adjuvant carboplatin and vinorelbine
followed by concomitant chemoradiotherapy in patients ≥70 years of age or with Karnofsky performance status (PS) 70-80, diagnosed
with locally advanced head and neck (H&N) or oesophageal carcinoma. Patients and Methods: The treatment plan consisted of
three courses of carboplatin AUC4 on day 1 and vinorelbine 25mg/m 2 on day 1 and 8, every 21 days, followed by chemoradiotherapy. Carboplatin 100 mg/m 2 was delivered weekly for the duration of the radiation therapy (70 Gy, 2 Gy/daily). Results: Thirty-five patients with an
average age of 68 years (range 42-85, 16 patients ≥70 years) were treated. Twenty-seven patients (77.1%) responded to neo-adjuvant
chemotherapy (2 complete and 25 partial responses). Haematological toxicity was grade 3-4 in 13 patients (37.2%), while gastrointestinal
toxicity was grade 3-4 in 20 patients (57.1%). All the patients completed the chemoradiotherapy plan, with grade 4 mucositis
plus febrile neutropenia in 3 patients (8.5%). Median time to progression (TTP) was 10.2 months, with 31.5% of patients being
alive at two years. Conclusion: The regimen of neo-adjuvant carboplatin and vinorelbine followed by chemoradiotherapy is feasible
and active in older (≥70 years) or low PS (Karnofsky 70-80) patients, although toxicity is not negligible and long-term outcome
remains poor.