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>Journals >Gaceta Médica de México >Year 2006, Issue 2

Bustamante-Valles FT, Calva-Espinosa AL, Gallegos- Hernández, JF Villalobos-Valencia R, Castruita AL, Silva JA, Flores-Díaz R
Concomitant treatment with Gemcitabine and radiotherapy in patients with advanced stages of epidermod carcinoma originating in the head and neck. A phase II study.
Gac Med Mex 2006; 142 (2)

Language: Español
References: 26
Page: 91-94
PDF: 444.83 Kb.

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Background: Surgery, radiotherapy or radiotherapy alone (RTA) constitute conventional treatment regimes for advanced stages of squamous cell carcinoma originating in the head and neck mucosa. Nevertheless, the results in advanced regional carcinoma (ARC) are disappointing. The chemotherapy – radiotherapy (CHT – RT) association has shown to be superior to RTA in irresectable disease and in resectable disease it could substitute initial surgery as a rescue alternative.
Objective: Our objective is to report the response rate and toxicity of concurrent treatment with Gemcitabine and Radiotherapy (GRT) in patients with ARC. In a prospective design, patients with ARC received concurrent GRT; the global, complete and partial response rate as well as toxicity were assessed.
Material and Methods: 15 patients were included, 5 women and 10 men, 73% in stage IVa; 13/15 showed a global response (87%), a complete response was observed in 9 cases (60%) (RC) and 2 showed progress.
Results: All patients included showed toxicity, the most frequent one was level 4 mucositis in 46%, of this 40% required nutritional support by catheter or gastrostomy. One patient in RC died due to sepsis. None of them suspended treatment.
Conclusion: The GRT association offers a complete response rate of 60%; nevertheless morbidity was not insignificant; randomized studies with a larger number of patients will be required to allow us to outline the optimal therapeutic scheme.

Key words: Chemotherapy, chemo-radiotherapy.


  1. Greenlee RT, Murray T, Bolden S, Wingo PA. Cancer statistics, 2000. CA Cancer J Clin 2000:50:7:33.

  2. Gallegos HJF, Arias GWR, Arias CH, Minauro MGG, Hernández SJM, Maffuz AA, y cols. Glosectomía transversa para el tratamiento del cáncer de lengua. Cir Ciruj 2004;72:11-13.

  3. Eng C, Vokes EE. Combined Mortality Strategies in the Treatment of Head and Neck Cancer of: Chemoradiation in Cancer Therapy, edited by: Hak COI. Humana Press, 2003. p. 146.

  4. Brizel DM, Albers ME, Fisher SR, Scher RL, Richstmeier WJ, Hars V, et al. Hyperfractionated irradiation with or without concurrent chemotherapy for locally advanced head and neck cancer. N Engl J Med 1998;338:1798-1804.

  5. Pignon JP, Bourhis J, Domenge C, Designe L. Chemotherapy added to locoregional treatment for head and neck squamous-cell carcinoma: three metaanalyses of updated individual data. MACH-NC Collaborative Group. Meta-analyses of Chemotherapy on Head and neck Cancer. Lancet 2000;355:949-955.

  6. Bourhis J, Pignon JP. Meta-analyses in head and neck squamous cell carcinoma. GAT is the role in chemotherapy? Hematol Oncol Clin Noth Am 1999;13:769-775,vii.

  7. Munro AJ. An overview of randomized controlled trials of adjuvant chemotherapy in head and neck cancer. Br J Cancer 1995:71:83-91.

  8. Durdux C. Cisplatin and derivatives with radiation therapy: for what clinical use? Cancer Radiother.2004;1S:88-94.

  9. Herscher LL, Cook JA, Pacelli R, Pass HL, Russo A, Mitchel JB. Principles of chemo radiation: theorical and practical considerations. Oncology (Huntington) 1999;13(10 suppl 5):11-22.

  10. Lawrence TS, Eisbrucch A, Mc Ginn CJ, Fields MT, Shewach DS. Radiosensitization by gemcitabine. Oncology (Willston Park) 1999;13(10 Suppl 5):55-60.

  11. Eisbruck A, Sheeach, Bradford CR, Littles JF, Teknos TN, Chepeha DB. Radiation concurrent with gemcitabine for locally advanced head and neck cancer. J Clin Oncol 2001;19:792-799.

  12. Mebis J, Schrijers D, Van den Weynagaert D. Phase II study of radiation in patients with head and neck cancer. Proc Annu Meet Am Soc Clin Oncol 2002;21:A2574.

  13. Khuri FR, Shin DM,Glisson BS, Lippman SM, Honk WK. Treatment of patients with recurrent or metastatic squamous cell carcinoma of the head and neck: current satatus and future directions. Semin Oncol 2000;27(4Suppl 8):25-33.

  14. Jaremtchuk V, Zarba J, Keropian M. Phase I study of gemcitabine combined with radiotherapy with or without amifostine in patients with locally advanced head and neck cancer. Proc Annu Meet Am Soc Clin Oncol 2000;19:A1674.

  15. Raguse JD, Gath JH, Bier J. Phase II trial of radiation therapy (RT) concurrent with gemcitabine (GEM) followed by chemotherapy with gem for unresectable SCCHN. Proc Annu Meet Am Soc Clin Oncol 2002;21;A963.

  16. Benasso M, Merlano M, Corvo R. Alternating/concomitant gemcitabine (GEM), cisplatin (CDDP) and radioterapia (RT) in advanced squamous cell carcinoma of the head and neck (SCC-HN). Proc Annu Meet Am Soc Clin Oncol 1998; 17:A1552.

  17. Athanasiadis I. Concomitant chemoradiotherapy with gemcitabine (GMZ) ± cisplatin (CDDP) and standard radiotherapy for locally advanced squamous cell carcinoma of head and neck (SCCHN). Proc Annu Meet Am Soc Clin Oncol 2002;21:A2.

  18. AJCC Cancer Staging Manual. 6th Ed. Springer. 2002.

  19. Rodríguez-Cuevas AS. Generalidades del cáncer de cabeza y cuello. En: Rodríguez-Cuevas AS. (Eds.) Tumores de cabeza y cuello. Manual Moderno. México, 2003. p. 1-21.

  20. Gallegos-Hernández JF, Cortés-Arroyo H, Labastida-Almendaro S, Reséndiz-Colosia JA, Flores-Díaz R, Gutiérrez-Carrillo F. Facteurs de pronostic s'agissant du cancer de l'oropharynx. En: Beauvillain de Montruil CH. Editor. EDK, París, Francia, 2002. p. 43-49.

  21. Temam S, Janot F. Facteurs pronostiques des carcinomes epidermoïdes des vois aéro-digestives supériores. En: Marandas P. Editor. Masson.París, Francia, 2004. p. 21-28.

  22. Aguilar-Ponce J, Granados-García M, Villavicencio V, Poitevin-Chacón A, Green D, Dueñas-González A, y cols. Phase II trial of gemcitabine concurrent with radiation for locally advanced squamous cell carcinoma of the head and neck. Ann Oncol 2004;15:301-306.

  23. Calais G, Alfonsi M, Bardet E, Sire C, Germain T, Bergerot P y cols. Randomized trial of radiation vs. concomitant chemotherapy and radiation for advanced stage oropharynx carcinoma J Natl Cancer Inst 1999;15:2081-2086.

  24. Eisbruch A, Schwartz M, Rasch C, Veineberg K, Damen E, Van As CJ, et al. Dysphagia and aspiration after chemoradiotherapy for head-and-neck cancer: which anatomic structures are affected and can they be spared by IMRT? Int J Radiat Oncol Biol Phys. 2004.1;60:1425-1439.

  25. León X, Ouer M, Orus C, Moran J, Retcher K. Results of an organ preservation protocol with induction chemotherapy and radiotherapy in patients with locally advanced pyriform sinus carcinoma. Eur Arch Otorhinolaryngol. 2002;259:32-36.

  26. Brockstein B, Vokes EE. Concurrent chemoradiotherapy for head and neck cancer. Semin Oncol 2004;31:786-793.

>Journals >Gaceta Médica de México >Year 2006, Issue 2

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