Toxicity profile of intensity-modulated radiation therapy for head and neck carcinoma and potential role of amifostine.

Abstract:

:Organ function preservation in patients with head and neck cancer can be achieved by intensity-modulated radiation therapy (IMRT). Much of the work on the physics of IMRT has been done for currently available IMRT systems. However, clinical data remain scarce. Before IMRT is accepted as a standard of care, more comprehensive clinical data on the outcomes of IMRT are needed to substantiate its superiority and advantages over conventional modes of radiotherapy. Concomitant chemoradiation and altered fractionation schemes improve local-regional control, but at the cost of increased toxicity. This article presents a 3-year update of the toxicity profile and therapeutic outcomes of 126 patients with head and neck carcinoma treated with IMRT. An ongoing trial of concomitant chemotherapy and IMRT with subcutaneous amifostine (Ethyol, WR-2721; MedImmune, Inc, Gaithersburg, MD) for organ function preservation is also discussed.

journal_name

Semin Oncol

journal_title

Seminars in oncology

authors

Chao KS,Ozyigit G,Thorsdad WL

doi

10.1053/j.seminoncol.2003.11.009

subject

Has Abstract

pub_date

2003-12-01 00:00:00

pages

101-8

issue

6 Suppl 18

eissn

0093-7754

issn

1532-8708

pii

S0093775403005712

journal_volume

30

pub_type

临床试验,杂志文章,评审
  • Management of borderline tumors of the ovary: state of the art.

    abstract::Evidence published during several decades has shown that there is a group of epithelial ovarian tumors having histological and biological features between those of clearly benign and frankly malignant tumors. In 1963, FIGO accepted an intermediate group of ovarian carcinomas of low malignant potential. In 1973, WHO ad...

    journal_title:Seminars in oncology

    pub_type: 杂志文章,评审

    doi:

    authors: Tropé C,Kaern J

    更新日期:1998-06-01 00:00:00

  • Daily oral etoposide in the treatment of cancer.

    abstract::Etoposide is one of the few cancer chemotherapy agents that is schedule-dependent in both preclinical and clinical studies. A randomized trial of etoposide as initial therapy in extensive small cell lung cancer (SCLC) demonstrated the superiority of a 5-day course versus the same total dose administered over 24 hours....

    journal_title:Seminars in oncology

    pub_type: 临床试验,杂志文章

    doi:

    authors: Einhorn LH

    更新日期:1991-02-01 00:00:00

  • Intraperitoneal cisplatin chemotherapy in the management of ovarian carcinoma.

    abstract::Phase I trials of the intraperitoneal (IP) administration of cisplatin have demonstrated that the drug can be safely delivered by this route with a major increase in exposure (approximately tenfold to 15-fold) of the cavity to the cytotoxic agent compared with that of the systemic circulation. Phase I trials of IP cis...

    journal_title:Seminars in oncology

    pub_type: 杂志文章,评审

    doi:

    authors: Markman M

    更新日期:1989-08-01 00:00:00

  • Combined modality treatment for prostate cancer: role of chemotherapy.

    abstract::Chemotherapy for prostate cancer currently has an established role in the treatment of hormone-refractory prostate cancer. There is strong evidence that combined modality treatment with androgen ablation in addition to radiotherapy provides a benefit above and beyond radiotherapy alone in patients with a poor prognosi...

    journal_title:Seminars in oncology

    pub_type: 杂志文章,评审

    doi:10.1016/s0093-7754(03)00274-4

    authors: Sandler HM,Narayan S,Smith DC

    更新日期:2003-08-01 00:00:00

  • Combination paclitaxel and platinum in the treatment of lung cancer: US experience.

    abstract::Despite marked improvements in the treatment options available for patients with lung cancers, more than 85% of patients ultimately relapse and die of their disease. Among the most auspicious of new agents available to treat lung cancers, paclitaxel (Taxol; Bristol-Myers Squibb Company, Princeton, NJ) also has been th...

    journal_title:Seminars in oncology

    pub_type: 杂志文章,评审

    doi:

    authors: Bunn PA Jr

    更新日期:1996-12-01 00:00:00

  • The expanding role of cisplatin in the treatment of non-small-cell lung cancer.

    abstract::Cisplatin has been employed in the treatment of non-small-cell lung cancer (NSCLC) since the late 1970s. Current evidence suggests that it may be the most effective single drug for the treatment of NSCLC patients. The overall response rate as a single agent is 21%, though responses are higher in previously untreated p...

    journal_title:Seminars in oncology

    pub_type: 杂志文章,评审

    doi:

    authors: Bunn PA Jr

    更新日期:1989-08-01 00:00:00

  • Serotonin antagonists in the management of cisplatin-induced emesis.

    abstract::Cisplatin is recognized as an active chemotherapeutic agent in a broad variety of human tumors. The severe emetic effects of cisplatin, however, result in both acute and delayed emesis syndromes causing considerable morbidity. Over the last decade, the standard of therapy for control of cisplatin-induced emesis has be...

    journal_title:Seminars in oncology

    pub_type: 杂志文章,评审

    doi:

    authors: Perez EA,Hesketh PJ,Gandara DR

    更新日期:1991-02-01 00:00:00

  • MicroRNAs in mutagenesis, genomic instability, and DNA repair.

    abstract::MicroRNAs (miRNAs) are aiding our understanding of cancer biology, and are now coming close to therapeutic use as well. Here, we focus specifically on the interaction between miRNAs and genomic instability. MiRNA regulation is essential to many cellular processes, and escape from this regulatory network seems to be a ...

    journal_title:Seminars in oncology

    pub_type: 杂志文章,评审

    doi:10.1053/j.seminoncol.2011.08.003

    authors: Landau DA,Slack FJ

    更新日期:2011-12-01 00:00:00

  • Modeling toxicity and response in carboplatin-based combination chemotherapy.

    abstract::Data from women with advanced ovarian cancer (International Federation of Gynecology and Obstetrics stage III or IV) were analyzed to evaluate the pharmacokinetic/pharmacodynamic relationships of carboplatin-based combination chemotherapy. With the equation area under the plasma concentration versus time curve (AUC) =...

    journal_title:Seminars in oncology

    pub_type: 临床试验,杂志文章,随机对照试验

    doi:

    authors: Egorin MJ,Reyno LM,Canetta RM,Jodrell DI,Swenerton KD,Pater JL,Burroughs JN,Novak MJ,Sridhara R

    更新日期:1994-10-01 00:00:00

  • Paclitaxel in the treatment of esophageal cancer.

    abstract::Since its introduction, paclitaxel (Taxol; Bristol-Myers Squibb Company, Princeton, NJ) has demonstrated significant antitumor activity in epidermoid carcinomas and adenocarcinomas originating in the esophagus. Paclitaxel is the most active single agent available to treat metastatic esophageal cancer. Combinations of ...

    journal_title:Seminars in oncology

    pub_type: 杂志文章,评审

    doi:

    authors: Weiner LM

    更新日期:1999-02-01 00:00:00

  • Paclitaxel pharmacokinetics and pharmacodynamics.

    abstract::Paclitaxel (Taxol; Bristol-Myers Squibb Company, Princeton, NJ) displays nonlinear pharmacokinetics in humans. Both peak plasma paclitaxel concentrations and areas under the curve (AUCs) of the concentration versus time profiles will change disproportionately to changes in dose. Models that accurately describe the pla...

    journal_title:Seminars in oncology

    pub_type: 杂志文章,评审

    doi:

    authors: Kearns CM,Gianni L,Egorin MJ

    更新日期:1995-06-01 00:00:00

  • Rituximab in combination with CHOP or fludarabine in low-grade lymphoma.

    abstract::Non-Hodgkin's lymphoma (NHL) is composed of a group of lymphoid malignancies that has been increasing in incidence at an annual rate of 4% to 7% over the last 20 years in both the United States and Europe. The reasons for this rise in incidence in NHL are not yet defined but most likely involve environmental exposures...

    journal_title:Seminars in oncology

    pub_type: 杂志文章

    doi:10.1053/sonc.2002.30152

    authors: Czuczman MS,Fallon A,Mohr A,Stewart C,Bernstein ZP,McCarthy P,Skipper M,Brown K,Miller K,Wentling D,Klippenstein D,Loud P,Rock MK,Benyunes M,Grillo-López AJ,Bernstein SH

    更新日期:2002-02-01 00:00:00

  • Vinorelbine (Navelbine) in the treatment of breast cancer: a summary.

    abstract::One of the new agents intensively studied in the last decade for the treatment of metastatic breast cancer is vinorelbine (Navelbine; Burroughs Wellcome Co, Research Triangle Park, NC; Pierre Fabre Médicament, Paris, France). This vinca alkaloid produces response rates comparable to other single agents in women with m...

    journal_title:Seminars in oncology

    pub_type: 杂志文章

    doi:

    authors: Abeloff MD

    更新日期:1995-04-01 00:00:00

  • Reirradiation of recurrent head and neck cancers with curative intent.

    abstract::In patients with recurrent, previously irradiated head and neck cancer, the traditional therapy of palliative single- or multi-agent chemotherapy yields a 30% to 40% response rate with median survival durations of 8 to 10 months. However, long-term survival is rarely observed. Reirradiation with or without concurrent ...

    journal_title:Seminars in oncology

    pub_type: 杂志文章,评审

    doi:10.1053/j.seminoncol.2004.09.003

    authors: Chmura SJ,Milano MT,Haraf DJ

    更新日期:2004-12-01 00:00:00

  • Fluorouracil versus folinic acid/fluorouracil in advanced colorectal cancer--preliminary results of a randomized trial.

    abstract::Patients with advanced colorectal cancer were randomized to receive either fluorouracil (5-FU) 370 mg/m2 IV days 1 to 5 followed by weekly applications of 5-FU 600 mg/m2 or the same doses of 5-FU preceded by folinic acid 200 mg/m2. Because of toxicity, the weekly 5-FU dose in the combination treatment schedule was red...

    journal_title:Seminars in oncology

    pub_type: 临床试验,杂志文章,随机对照试验

    doi:

    authors: Steinke B,Günther E,Hirschmann WD,Sondern W,Koniczek KH,Wander HE,Natt F,Wagner T,Hinrichs HF,Werdier D

    更新日期:1992-04-01 00:00:00

  • Overview of phase I trials of multitargeted antifolate (MTA, LY231514).

    abstract::Multitargeted antifolate (MTA, LY231514) is a novel antifolate antimetabolite, with antitumor activity via inhibition of thymidylate synthase, glycinamide formyl transferase, and dihydrofolate reductase. Three dosing schedules have been investigated in the phase I setting: daily x5 every 21 days, weekly x4 every 42 da...

    journal_title:Seminars in oncology

    pub_type: 杂志文章,评审

    doi:

    authors: Rinaldi DA

    更新日期:1999-04-01 00:00:00

  • Simultaneous treatment with single-agent chemotherapy and radiation for locally advanced cancer of the head and neck.

    abstract::A substantial proportion of patients with squamous cell carcinoma of the head and neck have extensive locoregional disease at presentation. While extensive surgical procedures may completely eradicate local disease with acceptable morbidity for smaller tumors, in patients with stage III and IV disease, high local rela...

    journal_title:Seminars in oncology

    pub_type: 杂志文章,评审

    doi:

    authors: Eisenberger M,Jacobs M

    更新日期:1992-08-01 00:00:00

  • Fludarabine: pharmacokinetics, mechanisms of action, and rationales for combination therapies.

    abstract::Knowledge of the pharmacokinetics of a drug is essential to the optimal design of the dose and schedule of chemotherapy protocols. As an extension, an understanding of the mechanism of drug action is necessary to construct the optimal strategy for combination chemotherapy. Nucleoside antimetabolites such as fludarabin...

    journal_title:Seminars in oncology

    pub_type: 杂志文章,评审

    doi:

    authors: Plunkett W,Gandhi V,Huang P,Robertson LE,Yang LY,Gregoire V,Estey E,Keating MJ

    更新日期:1993-10-01 00:00:00

  • Unraveling biologic therapy for Bcl-2-expressing malignancies.

    abstract::Cancer cells that express excessive levels of Bcl-2 pose a major problem in the delivery of curative therapy. Most treatments for such cancer involve chemotherapy to induce the apoptotic process. While these therapies often result in disease control for periods of time, failure to initiate apoptosis as a result of acq...

    journal_title:Seminars in oncology

    pub_type: 杂志文章,评审

    doi:10.1053/j.seminoncol.2004.10.014

    authors: Cotter FE

    更新日期:2004-12-01 00:00:00

  • VP-16 and cisplatin in the treatment of non-small-cell lung cancer.

    abstract::The EORTC Lung Cancer Working Party investigated the effects of combination therapy with VP-16 (Ve-Pesid) and cisplatin in the treatment of non-small-cell lung cancer (NSCLC). Neither agent alone is recognized as being associated with a high rate of response in NSCLC, but the combination proved beneficial in our hands...

    journal_title:Seminars in oncology

    pub_type: 杂志文章

    doi:

    authors: Klastersky J

    更新日期:1985-03-01 00:00:00

  • Psychosocial and sexual functioning of survivors of breast cancer.

    abstract::The literature documents that the majority of breast cancer survivors have adjusted well after their first 2 years since diagnosis. However, there is a subset of survivors reporting psychological distress, including depression and anxiety, involving approximately 30% by 4 years post-treatment, but widely ranging from ...

    journal_title:Seminars in oncology

    pub_type: 杂志文章,评审

    doi:10.1053/j.seminoncol.2003.08.025

    authors: Kornblith AB,Ligibel J

    更新日期:2003-12-01 00:00:00

  • Monoclonal antibodies for the prevention and treatment of graft-versus-host disease.

    abstract::Acute and chronic graft-versus-host disease (GvHD) remain major obstacles to successful allogeneic hematopoietic stem cell transplantation, contributing substantially to morbidity and non-relapse mortality. Better understanding of the immunopathophysiology of GvHD has identified a number of targets for intervention. A...

    journal_title:Seminars in oncology

    pub_type: 杂志文章,评审

    doi:10.1016/s0093-7754(03)00250-1

    authors: Bruner RJ,Farag SS

    更新日期:2003-08-01 00:00:00

  • Targeted agents for sarcoma: is individualized therapy possible in such a diverse tumor type?

    abstract::A wide variety of cytogenetic abnormalities and molecular pathways have been implicated in the pathogenesis of sarcoma, and significant progress has been made in the past decade toward identifying potential therapeutic targets. However, apart from gastrointestinal stromal tumors (GISTs) and dermatofibrosarcoma protube...

    journal_title:Seminars in oncology

    pub_type: 杂志文章,评审

    doi:10.1053/j.seminoncol.2011.09.003

    authors: Riedel RF

    更新日期:2011-10-01 00:00:00

  • Hodgkin's disease: the role of bone marrow transplantation.

    abstract::Because results with conventional salvage therapy remain disappointing, the approach of using high-dose therapy and bone marrow transplantation has gained increasing support in recent years. Several trials have now been reported using various conditioning regimens and hematopoietic rescue sources. Although it is not c...

    journal_title:Seminars in oncology

    pub_type: 杂志文章,评审

    doi:

    authors: Vose JM,Bierman PJ,Armitage JO

    更新日期:1990-12-01 00:00:00

  • Spirituality and healing.

    abstract::Spirituality can exert a tremendous impact on ones health and promote recovery from trauma and illness, including cancer. Throughout the history of mankind, spirituality and religion have played a major role in healing a variety of physical and mental illnesses. Cancer is one of the most devastating illnesses, as it a...

    journal_title:Seminars in oncology

    pub_type: 杂志文章

    doi:10.1053/j.seminoncol.2004.11.017

    authors: Torosian MH,Biddle VR

    更新日期:2005-04-01 00:00:00

  • The development of busulfan/cyclophosphamide preparative regimens.

    abstract::Bone marrow transplantation (BMT) preparative regimens consisting of busulfan (Bu) and cyclophosphamide (Cy) were developed as an alternative to preparative regimens based on total body irradiation (TBI). Animal studies demonstrated that Bu had a high level of myeloablative and antileukemic activity, but little immuno...

    journal_title:Seminars in oncology

    pub_type: 杂志文章,评审

    doi:

    authors: Santos GW

    更新日期:1993-08-01 00:00:00

  • Pharmacokinetics of paclitaxel and carboplatin in combination.

    abstract::We studied the pharmacokinetics of paclitaxel (Taxol; Bristol-Myers Squibb Company, Princeton, NJ) and carboplatin administered in combination to 21 patients with advanced non-small cell lung cancer. Paclitaxel was administered as a 24-hour intravenous infusion at doses of 135 to 200 mg/m2. Carboplatin, dosed to a tar...

    journal_title:Seminars in oncology

    pub_type: 临床试验,杂志文章

    doi:

    authors: Kearns CM,Belani CP,Erkmen K,Zuhowski M,Hiponia D,Zacharski D,Engstrom C,Ramanathan R,Trenn MR,Aisner J

    更新日期:1995-10-01 00:00:00

  • Therapy of superficial bladder cancer.

    abstract::Intravesical therapy has been used in the management of superficial transitional cell carcinoma (TCC) of the urinary bladder (Ie, Ta, Tl, and carcinoma in situ [CIS]) with specific objectives that include treating existing/residual tumor, preventing recurrence of tumor, preventing disease progression, and prolonging s...

    journal_title:Seminars in oncology

    pub_type: 杂志文章,评审

    doi:

    authors: Nseyo UO,Lamm DL

    更新日期:1996-10-01 00:00:00

  • Clinical experience with denileukin diftitox (ONTAK).

    abstract::Denileukin diftitox (ONTAK; Seragen Inc, San Diego, CA) is a fusion protein designed to direct the cytocidal action of diphtheria toxin to cells that overexpress the IL-2 receptor. The human IL-2 receptor exists in three isoforms: low (CD25), intermediate (CD122/CD132), and high (CD25/CD122/CD132) affinity. The high-a...

    journal_title:Seminars in oncology

    pub_type: 杂志文章,评审

    doi:10.1053/j.seminoncol.2005.12.017

    authors: Foss F

    更新日期:2006-02-01 00:00:00

  • Biochemotherapy for advanced melanoma.

    abstract::The outcome of chemotherapy for patients with stage IV melanoma is unsatisfactory, since durable responses are rarely achieved. More experimental treatments, such as vaccine approaches, antibody treatments, and gene therapy are being developed and are of high scientific interest; however, their efficacy in advanced me...

    journal_title:Seminars in oncology

    pub_type: 杂志文章,评审

    doi:10.1053/sonc.2002.35240

    authors: Keilholz U,Gore ME

    更新日期:2002-10-01 00:00:00