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Concurrent chemoradiotherapy using gemcitabine and nedaplatin in recurrent or locally advanced head and neck squamous cell carcinoma. | LitMetric

AI Article Synopsis

  • - Patients with recurrent or locally advanced head and neck squamous cell carcinoma (HNSCC) have limited treatment options and poor outcomes, prompting a study on the effectiveness of gemcitabine and nedaplatin combined with radiation therapy.
  • - In a study of 24 patients, both the objective response rate and disease control rate were 100%, with one-year overall survival at 75% and progression-free survival at 66.7%.
  • - Despite the promising efficacy, the treatment caused significant side effects, primarily hematological issues and mucositis, indicating that while this regimen is viable, further research is needed to optimize dosing and minimize adverse events.

Article Abstract

Background: Patients with recurrent or locally advanced head and neck squamous cell carcinoma (HNSCC) typically have limited treatment options and poor prognosis.

Aim: To evaluate the efficacy and safety of two drugs with potent radio-sensitization properties including gemcitabine and nedaplatin as concurrent chemoradiotherapy regimens in treating HNSCC.

Methods: This single-arm prospective study enrolled patients with HNSCC to receive gemcitabine on days 1 and 8 and nedaplatin on days 1 to 3 for 21 days. Intensity-modulated radiation therapy with a conventional fraction was delivered 5 days per week. Objective response rate (ORR), disease control rate, and toxicity were observed as primary endpoints. Overall survival (OS) and progression free survival were recorded and analyzed as secondary endpoints.

Results: A total of 24 patients with HNSCC were enrolled. During the median 22.4-mo follow-up, both ORR and disease control rate were 100%. The one-year OS was 75%, and one-year progression-free survival (PFS) was 66.7% (median PFS was 15.1 mo). Recurrent HNSCC patients had a poorer prognosis than the treatment-naïve patients, and patients who achieved complete response had better survival than those in the PR group (all < 0.05). The most common grade 1-4 (100%) or grade 3-4 toxicities (75%) were hematological, and the most common grade 3-4 non-hematological toxicity was mucositis in 17 (71%) patients.

Conclusion: Gemcitabine plus nedaplatin with concurrent chemoradiotherapy is a therapeutic option for HNSCC with predictable tolerability. Considering the high adverse event rate, the optimized dose and schedule must be further explored.

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Source
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC9048568PMC
http://dx.doi.org/10.12998/wjcc.v10.i11.3414DOI Listing

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