New Treatment Regimen Boosts Survival in Recurrent Head and Neck Cancer

By Martha Kerr

NEW YORK OCT 20, 2005 (Reuters Health) - A treatment regimen of re-irradiation, cisplatin and paclitaxel increases survival in recurrent head and neck cancer.  Those findings were announced this week at the annual meeting of the American Society for Therapeutic Radiation and Oncology (ASTRO) in Denver, Colorado.

Dr. Eric Horwitz of Fox Chase Cancer Center in Philadelphia, Pennsylvania, led a study of 99 patients with recurrent squamous-cell head and neck cancer (77%) or a second primary tumor in a previously irradiated site (23%).  Forty percent of primary sites occurred in the oropharynx and 27% occurred in the oral cavity. Mean patient age was 60, 76% were men and all patients had previously received radiation therapy. 

After a median of 40 months from initial radiation, patients received split-dose hyperfractionated radiation (twice a day for 5 days every two weeks for four cycles), cisplatin daily every two weeks for four cycles and paclitaxel daily every two weeks for four cycles. Mean Gy dose delivered was 60.

At this point, median follow-up is 23.6 months.  The one-year survival rate is 50%, and 26% of patients have survived two years with this regimen, Dr. Horwitz reported.

Dr. Horwitz commented in an interview with Reuters Health that median survival with chemotherapy alone, which is the current standard of treatment for recurrent head and neck cancer, is 6 to 8 months with 1-year survival rates around 35%. 

He added that one-third of the patients "appear to be cured, since some of them began treatment in 1999.  The expected two-year recurrence rate is 85% ... and I"m not sure these patients can be radiated again."

He acknowledged that side effects were significant but that "they absolutely can be managed."  The worst side effects occurred in the sickest patients, and the most prevalent was neutropenia related to chemotherapy. 

Patients in the study were not candidates for surgery.  "These patients now have options where they really didn"t before."


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