CC BY-NC-ND 4.0 · Indian J Med Paediatr Oncol 2010; 31(01): 4-7
DOI: 10.4103/0971-5851.68845
ORIGINAL ARTICLE

Comparison of vinorelbine with cisplatin in concomitant chemoradiotherapy in head and neck carcinoma

Devleena,
Anup Majumdar
Department of Radiotherapy, Institute of Postgraduate Medical Education and Research, Kolkata, India
,
Soumita Poddar
Department of Radiotherapy, Institute of Postgraduate Medical Education and Research, Kolkata, India
,
Anindya Chakraborty
Department of Radiotherapy, Institute of Postgraduate Medical Education and Research, Kolkata, India
› Author Affiliations
Source of Support Nil.

Abstract

Aim: Head and neck cancer is one of the most commonly occurring malignancies in the world. In India, the most commonly occurring head and neck cancers are those of the oral cavity and the pharynx. The majority of these cancers present with stage III/IV disease. Surgery and radiation therapy are the main treatment modalities. Concomitant chemoradiation is being investigated with the goal of improved local control that translates into improved survival. In this background, we have started this prospective randomized trial to ascertain the dose, schedule and sequence of therapy and to note whether Vinorelbine as radiosensitizer is equally effective as Cisplatin, comparing compliance, local control and toxicity. Patients and Methods: Forty patients of advanced head and neck cancer were randomized into two arms. Arm A received weekly injection Cisplatin 40mg/m 2 along with radiation. Arm B received weekly injection of Vinorelbine 6mg/m 2 along with radiation. Radiotherapy was delivered at a dose of 6,600-7,000 Gy in conventional fractionation in a telecobalt machine. Results: The complete response (CR) rate was higher in arm B (90%) than in arm A (70%). Major toxicities included neutropenia, anemia, mucositis and nausea. Conclusion: Concomitant chemoradiation with Vinorelbine produced more CR than chemoradiation with Cisplatin in advanced head and neck cancer. Toxicities were more in the Cisplatin arm, but they were manageable. Although a majority of the study was performed using Cisplatin as the radiosensitizer, Vinorelbine can be recommended as radiosensitizer in advanced head and neck malignancy.



Publication History

Article published online:
19 November 2021

© 2010. Indian Society of Medical and Paediatric Oncology. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial-License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/.)

Thieme Medical and Scientific Publishers Pvt. Ltd.
A-12, 2nd Floor, Sector 2, Noida-201301 UP, India

 
  • References

  • 1 Al-Sarraf M, LeBlanc M, Giri PG, Fu KK, Cooper J, Vuong T, et al. Chemoradiotherapy vs radiotherapy in patients with advanced nasopharyngeal cancer: Phase III randomized Intergroup study 0099. J Clin Oncol 1998;16:1310-7.
  • 2 Taylor SG 4th, Murthy AK, Vannetzel JM, Colin P, Dray M, Caldarelli DD, et al. Randomized comparison of neoadjuvant cisplatin and flurouracil infusion followed by radiation vs. concomitant treatment in advanced head and neck cancer. J Clin Oncol 1994;12:385-95.
  • 3 Coughlin CT, Richmond RC. Biologic and clinical developments of cisplatin combined with radiation: Concepts, utility, projections for new trials, and the emergence of carboplatin. Semin Oncol 1989;16:31-43.
  • 4 Pignon JP, Bourhis J, Domenge C, Designι L. Chemotherapy added to locoregional treatment for head and neck squamous-cell carcinoma: three meta-analyses of updated individual data. MACH-NC Collaborative Group. Meta-Analysis of Chemotherapy on Head and Neck Cancer. Lancet 2000;355:949-55.
  • 5 Staar S, Rudat V, Stuetzer H, Dietz A, Volling P, Schroeder M, et al. Intensified hyperfractionated accelerated radiotherapy limits the additional benefit of simultaneous chemotherapy--results of a multicentric randomized German trial in advanced head-and-neck cancer. Int J Radiat Oncol Biol Phys 2001;50:1161-71.
  • 6 Tannock IF. Combined modality treatment with radiotherapy and chemotherapy. Radiother Oncol 1989;16:83-101.completed.
  • 7 Induction chemotherapy plus radiation compared with surgery plus radiation in patients with advanced laryngeal cancer. The Department of Veterans Affairs Laryngeal Cancer Study Group. N Eng J Med 1991;324:1685-90.
  • 8 Potier P. The synthesis of Navelbine prototype of a new series of vinblastine derivatives. Semin Oncol 1989;16:2-4.
  • 9 Mastbergen SC, Duivenvoorden I, Versteegh RT, Geldof AA. Cell cycle arrest and clonogenic tumor cell kill by divergent chemotherapeutic drugs Anticancer Res 2000;20:1833-8.
  • 10 Sudarshan G, Mahadev S. Vinorelbine as radiosensitizer in head and neck and oesophageal cancer: A plot study. Journal of Clinical Oncology, 2004 Asco Annual meeting proceedings (post meeting edition) (July 15 supplement), 2004;22:5562.
  • 11 Grenman RA, Erjala KO, Pulkkiner JO, Kulmala JA, Alanen KA, Granma SE. Vinorelbine and concomitant irradiation in head and neck squamous cell cancer 2002 ASCO Annual Meeting Head and Neck Cancer: No: 257-7.
  • 12 Gasparini G, Pozza F, Recher G, Panizzoni GA, Cristoferi V, Squaquara R, et al. Simultaneous cis-platinum and radiotherapy in inoperable or locally advanced squamous cell carcinoma of the head and neck. Oncology 1991;48:270-6.
  • 13 Glaser MG, Leslie MD, O′Reilly SM, Cheesman AD, Newlands ES. Weekly cisplatinum concomitant with radical radiotherapy in the treatment of advanced head and neck cancer. Clin Oncol (R Coll Radiol) 1993;5:286-9.
  • 14 Chao CK, Ozyigit G, Tran BN. Pattern of failure in patients receiving definitive and post operative IMRT for head and neck cancer. Int J Radiat Oncol Biol Phys 2003;15:312.
  • 15 Adelstein DJ, Li Y, Adams GL, Wagner H Jr, Kish JA, Ensley JF, et al. An intergroup phase III comparison of standard radiation therapy and two schedules of concurrent chemo-radiotherapy in patients with unresectable squamous cell head and nack cancer. J Clin Oncol 2003:21:92-8.
  • 16 Calais G, Alfonsi M, Bardet E, Sire C, Germain T, Bergerot P, et al. Randomized trial of radiation therapy versus concomitant chemotherapy and radiotherapy for advanced-stage oropharynx carcinoma. J Natl Cancer Inst 1999;91:2081-6.