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Maintenance chemotherapy for high-risk patients. A preliminary report
Archives of Otolaryngology (Chicago, Ill. : 1960)
|November 1, 1985
Summary
This study shows that a combination of surgery, radiotherapy, and maintenance chemotherapy significantly improves disease-free survival for patients with extracapsular spread in cervical metastases. The treatment regimen demonstrated a high survival rate with minimal toxicity.
Area of Science:
- Oncology
- Head and Neck Cancer Treatment
Background:
- Extracapsular spread of tumor in cervical metastases indicates a poor prognosis.
- Standard treatment protocols often yield suboptimal survival rates for these patients.
Purpose of the Study:
- To evaluate the efficacy of a combined modality treatment program including surgery, radiotherapy, and maintenance chemotherapy.
- To assess the survival outcomes and toxicity profile of this intensive therapeutic approach.
Main Methods:
- A prospective study involving 32 patients with confirmed extracapsular spread in cervical metastases.
- Treatment consisted of surgery, postoperative radiotherapy (6,000 rad), and maintenance chemotherapy (methotrexate, fluorouracil, leucovorin) for six months.
- Patients were followed for 18 to 33 months.
Main Results:
- The determinate survival rate was 81% (21/32 patients alive and disease-free).
- This outcome significantly surpasses the 36% disease-free survival observed in concurrent controls.
- Toxic reactions were minimal and self-limiting, with only one patient discontinuing treatment due to toxicity.
Conclusions:
- The combined modality treatment program is highly effective in improving disease-free survival for patients with extracapsular spread in cervical metastases.
- This regimen offers a superior alternative to conventional treatments, with a favorable toxicity profile.
- Further research may explore optimizing this multimodal strategy for head and neck cancer management.