Laryngeal preservation in stage III/IV resectable laryngo‑hypopharyngeal squamous cell carcinoma following concurrent chemoradiotherapy with capecitabine/cisplatin

Ahn,Dongbin; Kim,Jae Hyug; Sohn,Jin  Ho; Sin,Chang‑Min; Lee,Jeong  Eun

doi:10.3892/mco.2013.113

Laryngeal preservation in stage III/IV resectable laryngo‑hypopharyngeal squamous cell carcinoma following concurrent chemoradiotherapy with capecitabine/cisplatin

Authors:
- Dongbin Ahn
- Jae Hyug Kim
- Jin Ho Sohn
- Chang‑Min Sin
- Jeong Eun Lee
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Affiliations: Department of Otorhinolaryngology‑Head and Neck Surgery, Kyungpook National University, Daegu 700‑712, Republic of Korea, Department of Radiation Oncology, Kyungpook National University, Daegu 700‑712, Republic of Korea
Published online on: May 9, 2013 https://doi.org/10.3892/mco.2013.113
Pages: 685-691

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Abstract

Concurrent chemoradiotherapy has become the standard of care for advanced head and neck cancers in organ preservation strategies. However, the optimal regimen for concurrent chemoradiotherapy to maximise treatment response and minimise toxicity has not been determined. The purpose of the present clinical study was to review our experience with concurrent chemoradiotherapy by using the capecitabine and cisplatin (XP) regimen with the aim of organ preservation in patients with locoregionally advanced laryngo‑hypopharyngeal squamous cell carcinoma (LHSCC). Thirty‑one patients with stage III/IV resectable LHSCC treated with concurrent chemoradiotherapy using the XP regimen were enrolled in the present study. The patients fulfilled the criteria for total laryngectomy when surgery was selected. The primary endpoint of this study was disease‑free survival with a functional larynx, which was indicated by the following conditions: survival, disease‑free status at all sites and retention of a functional larynx. Following concurrent chemoradiotherapy, 23 patients (74.2%) exhibited complete response (CR) at the primary site and 18 (69.2%) exhibited CR at the lymph nodes. CR at the primary site and lymph nodes was identified in 19 patients (61.3%). The Kaplan‑Meier 2‑ and 3‑year cumulative disease‑free survival rates were 71.5 and 59.6%, respectively. Anatomical laryngeal preservation was feasible in 27 patients (87.1%) during the 36‑month follow‑up period. Permanent gastrostomy was required in 1 disease‑free patient with an intact larynx. For the entire cohort, the 2‑ and 3‑year cumulative disease‑free survival with a functional larynx was 58.5 and 50.7%, respectively. The most frequent grade 3‑4 haematological and non‑haematological toxicities of concurrent chemoradiotherapy were leucopenia and mucositis, which developed in 4 (12.9%) and 8 (25.8%) patients, respectively. There was no treatment‑related death. Concurrent chemoradiotherapy with the XP regimen resulted in functional laryngeal preservation accompanied by disease‑free survival and the toxicities were more tolerable and manageable compared to those reported by previous studies.

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1.	Kim JG, Sohn SK, Kim DH, et al: Phase II study of concurrent chemoradiotherapy with capecitabine and cisplatin in patients with locally advanced squamous cell carcinoma of the head and neck. Br J Cancer. 93:1117–1121. 2005. View Article : Google Scholar : PubMed/NCBI
2.	Brizel DM, Albers ME, Fisher SR, et al: Hyperfractionated irradiation with or without concurrent chemotherapy for locally advanced head and neck cancer. N Engl J Med. 338:1798–1804. 1998. View Article : Google Scholar : PubMed/NCBI
3.	Pignon JP, Bourhis J, Domenge C and Designé L: Chemotherapy added to locoregional treatment for head and neck squamous-cell carcinoma: three meta-analyses of updated individual data. MACH-NC Collaborative Group. Meta-Analysis of Chemotherapy on Head and Neck Cancer. Lancet. 355:949–955. 2000. View Article : Google Scholar : PubMed/NCBI
4.	Forastiere AA, Goepfert H, Maor M, et al: Concurrent chemotherapy and radiotherapy for organ preservation in advanced laryngeal cancer. N Engl J Med. 349:2091–2098. 2003. View Article : Google Scholar : PubMed/NCBI
5.	Rodriguez CP, Adelstein DJ, Rybicki LA, et al: Clinical predictors of larynx preservation after multiagent concurrent chemoradiotherapy. Head Neck. 30:1535–1542. 2008. View Article : Google Scholar : PubMed/NCBI
6.	Clavel M, Vermorken JB, Cognetti F, et al: Randomized comparison of cisplatin, methotrexate, bleomycin and vincristine (CABO) versus cisplatin and 5-fluorouracil (CF) versus cisplatin (C) in recurrent or metastatic squamous cell carcinoma of the head and neck. A phase III study of the EORTC Head and Neck Cancer Cooperative Group. Ann Oncol. 5:521–526. 1994.
7.	Jacobs C: Head and neck cancer in 1994: a change in the standard of care. J Natl Cancer Inst. 86:250–252. 1994. View Article : Google Scholar : PubMed/NCBI
8.	Blum JL, Jones SE, Buzdar AU, et al: Multicenter phase II study of capecitabine in paclitaxel-refractory metastatic breast cancer. J Clin Oncol. 17:485–493. 1999.PubMed/NCBI
9.	Hoff PM, Ansari R, Batist G, et al: Comparison of oral capecitabine versus intravenous fluorouracil plus leucovorin as first-line treatment in 605 patients with metastatic colorectal cancer: results of a randomized phase III study. J Clin Oncol. 19:2282–2292. 2001.
10.	Van Cutsem E, Twelves C, Cassidy J, et al: Oral capecitabine compared with intravenous fluorouracil plus leucovorin in patients with metastatic colorectal cancer: results of a large phase III study. J Clin Oncol. 19:4097–4106. 2001.
11.	World Health Organization: WHO Handbook for Reporting Results of Cancer Treatment: World Health Organization. Geneva, Switzerland: 1979
12.	Bussu F, Paludetti G, Almadori G, et al: Comparison of total laryngectomy with surgical (cricohyoidopexy) and nonsurgical organ-preservation modalities in advanced laryngeal squamous cell carcinomas: a multicenter retrospective analysis. Head Neck. 35:554–561. 2013. View Article : Google Scholar
13.	Induction chemotherapy plus radiation compared with surgery plus radiation in patients with advanced laryngeal cancer. The Department of Veterans Affairs Laryngeal Cancer Study Group. N Engl J Med. 324:1685–1690. 1991. View Article : Google Scholar : PubMed/NCBI
14.	Lefebvre JL, Chevalier D, Luboinski B, Kirkpatrick A, Collette L and Sahmoud T: Larynx preservation in pyriform sinus cancer: preliminary results of a European Organization for Research and Treatment of Cancer phase III trial. EORTC Head and Neck Cancer Cooperative Group. J Natl Cancer Inst. 88:890–899. 1996. View Article : Google Scholar
15.	Lefebvre JL, Rolland F, Tesselaar M, et al: Phase 3 randomized trial on larynx preservation comparing sequential vs. alternating chemotherapy and radiotherapy. J Natl Cancer Inst. 101:142–152. 2009. View Article : Google Scholar : PubMed/NCBI
16.	Veronesi A, Zagonel V, Tirelli U, et al: High-dose versus low-dose cisplatin in advanced head and neck squamous carcinoma: a randomized study. J Clin Oncol. 3:1105–1108. 1985.PubMed/NCBI
17.	Yoon TM, Lee JK, Cho JS, Lim SC and Chung WK: Role of concurrent chemoradiation in laryngeal preservation for supraglottic cancer. J Otolaryngol Head Neck Surg. 39:142–149. 2010.PubMed/NCBI
18.	Kubota A, Furukawa M, Hanamura H, Fujita Y and Sugiyama M: Concurrent chemoradiotherapy for squamous cell carcinoma of the oropharynx. Nihon Jibiinkoka Gakkai Kaiho. 110:635–642. 2007.(In Japanese).
19.	Won YW, Park YH, Ahn MJ, Do IG, Ko YH and Park K: A phase II study of combination chemotherapy with capecitabine and cisplatin in patients with metastatic or recurrent squamous cell carcinoma of the head and neck. Ann Oncol. 22:417–423. 2011. View Article : Google Scholar : PubMed/NCBI
20.	Pivot X, Chamorey E, Guardiola E, et al: Phase I and pharmaco-kinetic study of the association of capecitabine-cisplatin in head and neck cancer patients. Ann Oncol. 14:1578–1586. 2003. View Article : Google Scholar : PubMed/NCBI
21.	Adelstein DJ, Li Y, Adams GL, et al: An intergroup phase III comparison of standard radiation therapy and two schedules of concurrent chemoradiotherapy in patients with unresectable squamous cell head and neck cancer. J Clin Oncol. 21:92–98. 2003. View Article : Google Scholar : PubMed/NCBI
22.	Vokes EE, Kies MS, Haraf DJ, et al: Concomitant chemoradio-therapy as primary therapy for locoregionally advanced head and neck cancer. J Clin Oncol. 18:1652–1661. 2000.PubMed/NCBI
23.	Schuller J, Cassidy J, Dumont E, et al: Preferential activation of capecitabine in tumor following oral administration to colorectal cancer patients. Cancer Chemother Pharmacol. 45:291–297. 2000. View Article : Google Scholar : PubMed/NCBI
24.	Sawada N, Ishikawa T, Sekiguchi F, Tanaka Y and Ishitsuka H: X-ray irradiation induces thymidine phosphorylase and enhances the efficacy of capecitabine (Xeloda) in human cancer xenografts. Clin Cancer Res. 5:2948–2953. 1999.PubMed/NCBI
25.	Richard JM, Sancho-Garnier H, Pessey JJ, et al: Randomized trial of induction chemotherapy in larynx carcinoma. Oral Oncol. 34:224–228. 1998. View Article : Google Scholar : PubMed/NCBI