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Long-Term Results of a Multimodal Intensification Regimen for Previously Untreated Advanced Resectable Squamous Cell Cancer of the Oral Cavity, Oropharynx, or Hypopharynx

Authors

  • Enver Ozer MD,

    Corresponding author
    1. Department of Otolaryngology–Head and Neck Surgery, Comprehensive Cancer Center, The Ohio State University, Columbus, Ohio, U.S.A.
    • Dr. Enver Ozer, ENT Department, Gaziantep University Hospital, Sahinbey, Gaziantep, Turkey, 27060
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  • John C. Grecula MD,

    1. Division of Radiation Oncology, Comprehensive Cancer Center, The Ohio State University, Columbus, Ohio, U.S.A.
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  • Amit Agrawal MD,

    1. Department of Otolaryngology–Head and Neck Surgery, Comprehensive Cancer Center, The Ohio State University, Columbus, Ohio, U.S.A.
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  • Chris A. Rhoades MD,

    1. Division of Medical Oncology, Comprehensive Cancer Center, The Ohio State University, Columbus, Ohio, U.S.A.
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  • Donn C. Young PhD,

    1. Biostatistics Unit, Arthur G. James Cancer Hospital and Richard J. Solove Research Institute, Comprehensive Cancer Center, The Ohio State University, Columbus, Ohio, U.S.A.
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  • David E. Schuller MD

    1. Department of Otolaryngology–Head and Neck Surgery, Comprehensive Cancer Center, The Ohio State University, Columbus, Ohio, U.S.A.
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  • Supported in part by grant P30 CA16058, National Cancer Institute, Bethesda, Maryland, U.S.A, The Ohio State University Comprehensive Cancer Center Head and Neck Oncology Group, Columbus, Ohio, U.S.A., and the Arthur G. James Cancer Hospital and Richard J. Solove Research Institute, Columbus, Ohio, U.S.A. Presented at the 6th international symposium of the American Head and Neck Society, August 7–11, 2004, Washington, DC, U.S.A.

Abstract

Background: Long-term disease control of an intensified treatment regimen for previously untreated stage III and IV resectable oral cavity, oropharyngeal, or hypopharyngeal squamous cell carcinoma was analyzed.

Methods: Forty-three patients with previously untreated, advanced stage, resectable squamous carcinomas of the oral cavity, oropharynx, or hypopharynx were enrolled in a prospective phase II institutional clinical trial at a tertiary care National Cancer Institute-designated comprehensive cancer center. It includes preoperative accelerated hyperfractionated radiotherapy with concurrent cisplatin followed immediately by surgery and intraoperative radiotherapy, and completed with early postoperative weekly paclitaxel, two additional cisplatin cycles, and concurrent once-daily radiotherapy beginning on day 28 after surgery.

Results: Forty-three patients enrolled in the study. Protocol compliance was 53%. The range of time at risk was 10.4 to 56.23 months (median, 45 months). The locoregional (93%) and systemic (91%) disease control rates were excellent. Overall long-term survival was 79%.

Conclusions: An intensive treatment regimen that improves compliance and long-term disease control is clearly feasible for this patient population.

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