Table 5 Summary of induction chemotherapy followed by (chemo)-radiotherapy
| Â | Leeds | RMH, UK (19) | Posner et al (15) | Hitt et al (16) | Vokes et al (20) | Machtay et al (21) | Urba et al (22) |
|---|---|---|---|---|---|---|---|
Sequential theapy (IC + CRT) | IC: PF 1-4 cycles CRT (70 Gy in 35# Cisplatin100 m g/m2 day 1, 22, 43)/55 gy in20# Cisplatin day 1, 28 | IC: P(75 mg/m 2)5 Fu(1000 mg/m2 for 4 days)-2 cycles + CRT :65 Gy in 30# with cisplatin 100 mg/m2 on day 1 & 29) | Control arm: IC: cisplatin (100 mg/m2) 5 FU(1000 mg/m2/day)-5 days CRT: 70-74 Gy with weekly carboplatin AUC 1.5 | Control arm: IC:3 cisplatin100 m g/m2 5-FU1000 mg/m2-5 days-3 cycles CRT: 70 gy IN 35# Cisplatin100 mg/m2 on day 1, 22, 43 | IC: Paclitaxel/carbo platin weekly × 6 followed by CRT: paclitaxel, 5-FU, hydroxyurea and twice daily radiation therapy every other week | IC: caboplatin/pa clitaxel-2 cycles CRT: 70 in 35f with Concurrent Weekly paclitaxel Adjuvant chemo(2 cycles of carbo/taxol) + neck dissection in N2/N3 patients | IC: Cisplatin 100 mg/m2, 5 FU 1000 mg/m2 5 days-2 cycles CRT: 72 Gy + cisplatin 100 mg/m2 day 1, 22, 43 |
Response | IC: 78%(overall) | IC: 76%(overall) | IC: 64% (overall) | IC: 68%(overall) | IC: 87%(overall) | IC:89%(over all) | IC: 76%(overall) |
| Â | CRT: 85%(CR) | CRT: 79%(CR) | Â | CRT: 78% (CR) | CRT:82% (CR) | CRT:90% (CR) | CRT:54% histological CR |
Overall survival (OS), disease free survival (DFS) | 65%(3 YR OS) | 63% (2 YR OS) | 48% (3 YR OS) | 61.5% (2 YR OS) | 70% (3 YR OS) | 70% (3 YR OS) | 64%(3 YR OS) |
| Â | 75%(3 YR DFS) | 68% (2 YR DFS) | Â | Â | 80% (3 YR DFS) | Â | Â |
Logo-regionalcontrol (LRC) | 91% in complete responders at 3 yrs | 71% at 2 yrs | 62% | NR | 94% (2 YR LRC) | 82% at 3 YRS | NR |
Metastasi s-free survival | 89% AT 3 yrs | 91% at 2 yrs | 91% | NR | 93% AT 2 YRS | 81% ay 3 YRS | NR |
Toxicity-Acute (AC), Late (LT) Gr3/4 only | IC: neutropenia 10%, mucositis 5% CRT: 75% skin, 70%mucositis, dysphagia 63% Late: 24% | IC: neutropenia 5%, n&v 3% CRT: mucositis 60%, dysphagia 72%; Late: 8% | IC: neutropenia 56%, mucositis 27% CRT: mucositis38%, dysphagia 24% | IC: neutropenia 36%, mucositis(gr2-4) 53% CRT: 4 toxic deaths | IC:36%neutropenia CRT: 76% mucositis, 61% skin | CRT: 98%mucositis Late: 24% Treatment mortality: 4% | IC: 29% grade4 CRT:19% grade4 Haematological |
No of patients | 41 | 145 | 246 | 193 | 69 | 53 | 59 |
Cancer site/staging | All Tonsil All stage 4 | Oropharynx 54% Stage4 60% | Oropharynx 53% Stage 4 81% | Oropharynx 35% Stage 4 83% | Oropharynx 44% Stage 4 96% | All Oropharynx Stage 4 65% | Oropharynx 62%tongue base Stage 4 58% |