Concurrent Chemoradiotherapy Using Cisplatin, Tegafur, and Leucovorin for Advanced Squamous Cell Carcinoma of the Hypopharynx and Oropharynx

Biomed J. May-Jun 2014;37(3):133-40. doi: 10.4103/2319-4170.117893.

Abstract

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.

MeSH terms

  • Adult
  • Aged
  • Antineoplastic Combined Chemotherapy Protocols / therapeutic use
  • Carcinoma, Squamous Cell / radiotherapy*
  • Chemoradiotherapy / methods
  • Cisplatin / administration & dosage
  • Cisplatin / therapeutic use*
  • Disease-Free Survival
  • Female
  • Head and Neck Neoplasms / radiotherapy
  • Humans
  • Hypopharynx / drug effects*
  • Leucovorin / administration & dosage
  • Leucovorin / therapeutic use*
  • Male
  • Middle Aged
  • Neoplasm Staging
  • Oropharynx / drug effects*
  • Tegafur / administration & dosage
  • Tegafur / therapeutic use*
  • Treatment Outcome

Substances

  • Tegafur
  • Cisplatin
  • Leucovorin