fa Alternating chemotherapy: Gemcitabine and cisplatin with concurrent radiotherapy for treatment of advanced head and neck cancer جراحی دهان، فک و صورت Oral and Maxillofacial Surgery پژوهشي Research <p> <strong>Background </strong></p><p> Many studies have shown gemcitabine and cisplatin are radiosensitizers. Concurrent chemoradiation seems to be an efficient approach for treatment of advanced head and neck cancer (HNC), but toxicity is significant. </p><p> <strong>Objective</strong></p><p>  To evaluate safety and explore efficacy of alternating chemotherapy with gemcitabine and cisplatin concurrent with radiotherapy in patients with advanced non-metastatic HNC. </p><p> <strong>Patients and Methods</strong> </p><p> Twenty-eight patients diagnosed with advanced Squamous Cell Carcinomas of the Head and Neck (SCCHN) in stages III (28%), IVa (36%), and IVb (36%) were treated with gemcitabine: 100mg/m2 alternating with cisplatin: 50mg/m2 concurrent with radiotherapy at doses of 2Gy/day until completing 70Gy. While awaiting for concurrent treatment, eleven patients received induction chemotherapy with cisplatin: 100mg/m2 and 5-FU: 1000mg/m2. Toxicity, especially in relation to mucositis, xerostomy, dysphagia, leucopenia and radiodermitis was evaluated. </p><p> <strong>Results</strong> </p><p> 5-year progression-free survival was 27.8±17.2% (CI-95: 0–61.5) and overall survival was 55.9±11% (CI: 34.4–77.5). Overall response rate was 93% complete response was 64.3% and partial response was 28.6%. Extensive surgery for primary site was avoided in 19 patients (70.4%). Grade 3–4 adverse events were mucositis (46.4%), leucopenia (14.2%), dysphagia (25%), xerostomy (10.7%) and radiodermitis (3.6%). Response rates and toxicity were not significantly different among those patients with and without induction chemotherapy, but survival was higher in patients receiving induction.</p><p> <strong> Conclusions</strong></p><p>  Gemcitabine alternating with cisplatin concurrent with radiotherapy is an active and safe treatment that deserves further study. </p><hr><p></p><p> <strong>Source: </strong>Journal of Oral Oncology</p><p><a href="http://www.oraloncology.com/article/S1368-8375(12)00298-9/abstract" target="_blank"><font color="#0000ff"> Full Text</font></a></p> Head and neck cancer, Oral cancer, Radiotherapy, Chemotherapy, Alternating chemotherapy, Concurrent chemoradiation 0 0 http://idai.ir/browse.php?a_code=A-10-32-2453&slc_lang=fa&sid=1 J.L. Aguilar-Ponce 100319475328460011672 100319475328460011672 Yes Department of Medical Oncology, Instituto Nacional de Cancerología, Mexico City, Mexico M. Granados-García 100319475328460011673 100319475328460011673 No Department of Surgery, Instituto Nacional de Cancerología, Mexico City, Mexico J.C. Cruz López 100319475328460011674 100319475328460011674 No Department of Oncology, ISSSTE, Puebla, Mexico F. Maldonado-Magos 100319475328460011675 100319475328460011675 No Department of Radiotherapy, Instituto Nacional de Cancerología, Mexico City, Mexico M.A. Alvarez-Avitia 100319475328460011676 100319475328460011676 No Department of Medical Oncology, Instituto Nacional de Cancerología, Mexico City, Mexico O. Arrieta 100319475328460011677 100319475328460011677 No Department of Basic Investigation, Instituto Nacional de Cancerología, Mexico City, Mexico I. González-Ramírez 100319475328460011678 100319475328460011678 No Department of Basic Investigation, Instituto Nacional de Cancerología, Mexico City, Mexico G. Lara-Cruz 100319475328460011679 100319475328460011679 No Department of Surgery, Instituto Nacional de Cancerología, Mexico City, Mexico I. Martinez-Juárez 100319475328460011680 100319475328460011680 No Department of Surgery, Instituto Nacional de Cancerología, Mexico City, Mexico R. Medina-Santillan 100319475328460011681 100319475328460011681 No College of Medicine, Instituto Politecnico Nacional, Mexico City, Mexico