RESUMEN
Background Our previous phase-3 study (TTCC 2503) failed to show overall survival advantage of 2 induction chemotherapy (IC) regimens followed by standard concurrent chemoradiotherapy (CRT) over CRT alone in patients with unresectable locally advanced head and neck squamous-cell carcinoma (LAHNSCC). This study described the long-term survival of those patients. Materials and methods Long-term follow-up study of patients with untreated LAHNSCC assigned to IC (three cycles), with either docetaxel, cisplatin and 5-fluorouracil (TPF arm) or cisplatin and 5-fluorouracil (PF arm), followed by CRT, or CRT alone, included in the previous TTCC 2503 trial. Results In the intention-to-treat population (n = 439), the median OS times were 25.4 (95% CI, 16.834.4), 26.2 (95% CI, 18.236.6) and 25.4 months (95% CI, 17.436.0) in the TPF-CRT, PF-CRT and CRT arms, respectively (log-rank p = 0.51). In the per-protocol population (n = 355), patients with larynxhypopharynx primary tumors treated with IC (TPF or PF) followed by CRT had a longer median PFS than those who received CRT alone. Moreover, patients with ECOG 0 treated with IC (TPF or PF) followed by CRT had a better TTF than those with CRT alone. There were no statistically significant differences in terms of OS, PFS or TTF, according to the tumor load or affected nodes. Conclusion After a long follow-up, the TTCC 2503 trial failed to show the benefit of IC-CRT in unresectable LAHNSCC regarding the primary end point. However, fit patients with ECOG 0 and primary larynxhypopharyngeal tumors may benefit from the use of IC if administered by an experienced team (AU)
Asunto(s)
Humanos , Protocolos de Quimioterapia Combinada Antineoplásica , Quimioradioterapia , Quimioterapia de Inducción , Neoplasias de Cabeza y Cuello/tratamiento farmacológico , Carcinoma de Células Escamosas de Cabeza y Cuello/tratamiento farmacológico , Cisplatino/administración & dosificación , Docetaxel/administración & dosificación , Fluorouracilo/administración & dosificación , Estudios de Seguimiento , Neoplasias de Cabeza y Cuello/mortalidad , Supervivencia sin Progresión , Estudios Retrospectivos , Carcinoma de Células Escamosas de Cabeza y Cuello/mortalidad , Resultado del TratamientoRESUMEN
BACKGROUND: Our previous phase-3 study (TTCC 2503) failed to show overall survival advantage of 2 induction chemotherapy (IC) regimens followed by standard concurrent chemoradiotherapy (CRT) over CRT alone in patients with unresectable locally advanced head and neck squamous-cell carcinoma (LAHNSCC). This study described the long-term survival of those patients. MATERIALS AND METHODS: Long-term follow-up study of patients with untreated LAHNSCC assigned to IC (three cycles), with either docetaxel, cisplatin and 5-fluorouracil (TPF arm) or cisplatin and 5-fluorouracil (PF arm), followed by CRT, or CRT alone, included in the previous TTCC 2503 trial. RESULTS: In the intention-to-treat population (n = 439), the median OS times were 25.4 (95% CI, 16.8-34.4), 26.2 (95% CI, 18.2-36.6) and 25.4 months (95% CI, 17.4-36.0) in the TPF-CRT, PF-CRT and CRT arms, respectively (log-rank p = 0.51). In the per-protocol population (n = 355), patients with larynx-hypopharynx primary tumors treated with IC (TPF or PF) followed by CRT had a longer median PFS than those who received CRT alone. Moreover, patients with ECOG 0 treated with IC (TPF or PF) followed by CRT had a better TTF than those with CRT alone. There were no statistically significant differences in terms of OS, PFS or TTF, according to the tumor load or affected nodes. CONCLUSION: After a long follow-up, the TTCC 2503 trial failed to show the benefit of IC-CRT in unresectable LAHNSCC regarding the primary end point. However, fit patients with ECOG 0 and primary larynx-hypopharyngeal tumors may benefit from the use of IC if administered by an experienced team. ClinicalTrials.gov identifier NCT00261703.
Asunto(s)
Protocolos de Quimioterapia Combinada Antineoplásica/uso terapéutico , Quimioradioterapia , Neoplasias de Cabeza y Cuello/mortalidad , Quimioterapia de Inducción , Carcinoma de Células Escamosas de Cabeza y Cuello/mortalidad , Cisplatino/uso terapéutico , Ensayos Clínicos Fase III como Asunto , Intervalos de Confianza , Docetaxel/uso terapéutico , Fluorouracilo/uso terapéutico , Estudios de Seguimiento , Neoplasias de Cabeza y Cuello/tratamiento farmacológico , Neoplasias de Cabeza y Cuello/patología , Neoplasias de Cabeza y Cuello/terapia , Humanos , Neoplasias Hipofaríngeas/tratamiento farmacológico , Neoplasias Hipofaríngeas/mortalidad , Neoplasias Hipofaríngeas/patología , Neoplasias Hipofaríngeas/terapia , Análisis de Intención de Tratar , Neoplasias Laríngeas/tratamiento farmacológico , Neoplasias Laríngeas/mortalidad , Neoplasias Laríngeas/patología , Neoplasias Laríngeas/terapia , Neoplasias de la Boca/tratamiento farmacológico , Neoplasias de la Boca/mortalidad , Neoplasias de la Boca/patología , Neoplasias de la Boca/terapia , Supervivencia sin Progresión , Ensayos Clínicos Controlados Aleatorios como Asunto , Estudios Retrospectivos , Carcinoma de Células Escamosas de Cabeza y Cuello/tratamiento farmacológico , Carcinoma de Células Escamosas de Cabeza y Cuello/patología , Carcinoma de Células Escamosas de Cabeza y Cuello/terapia , Taxoides/uso terapéutico , Resultado del Tratamiento , Carga TumoralAsunto(s)
Anticuerpos Monoclonales/efectos adversos , Antineoplásicos/efectos adversos , Neoplasias de la Coroides/tratamiento farmacológico , Melanoma/tratamiento farmacológico , Sarcoidosis/inducido químicamente , Enfermedades de la Piel/inducido químicamente , Piel/efectos de los fármacos , Biopsia , Neoplasias de la Coroides/inmunología , Neoplasias de la Coroides/patología , Clobetasol/uso terapéutico , Femenino , Glucocorticoides/uso terapéutico , Humanos , Ipilimumab , Melanoma/inmunología , Melanoma/secundario , Persona de Mediana Edad , Sarcoidosis/diagnóstico , Sarcoidosis/tratamiento farmacológico , Piel/patología , Enfermedades de la Piel/diagnóstico , Enfermedades de la Piel/tratamiento farmacológico , Resultado del TratamientoRESUMEN
Propósito: Descripción de un caso de NOA bilateral de cabeza femoral como complicación del tratamiento con quimioterapia de la EH. Valoramos la necesidad de un diagnóstico precoz de esta complicación. Material y métodos: Varón de 28 años diagnosticado de EH tratado con quimioterapia. Presenta NOA bilateral de cabeza femoral a los 10 meses de finalizado el tratamiento. Conclusiones: El seguimiento en pacientes con EH tratados con quimioterapia mediante radiografía simple de las articulaciones coxofemorales, puede ser útil en el diagnóstico precoz de la NOA (AU)
Asunto(s)
Adulto , Masculino , Humanos , Enfermedad de Hodgkin/terapia , Enfermedad de Hodgkin/tratamiento farmacológico , Osteonecrosis/complicaciones , Osteonecrosis/diagnósticoAsunto(s)
Anafilaxia/etiología , Antineoplásicos/efectos adversos , Factor Estimulante de Colonias de Granulocitos/efectos adversos , Factor Estimulante de Colonias de Granulocitos y Macrófagos/efectos adversos , Adolescente , Femenino , Factor Estimulante de Colonias de Granulocitos y Macrófagos/uso terapéutico , Enfermedad de Hodgkin/tratamiento farmacológico , HumanosRESUMEN
Interleukin-2 (IL2), as a modifier of the biological response, has been intravenously used in patients with advanced cancer associated or not to LAK cells or tumor infiltrating lymphocytes. In different neoplasias positive results have been obtained, being effective in melanoma and renal cancer. There are still, at present, many questions to be answered and multiple research lines are currently open. The association with other cytokines and new chemotherapy protocols grant new therapeutic possibilities.