Is there a survival benefit to combination chemotherapy with cisplatin?
In contrast to the findings in some RCTs, we found no survival benefit to the use of cisplatin containing combination chemotherapy rather than combinations based on carboplatin. However, as has been previously observed, cisplatin was associated with more frequent hospitalizations, outpatient visits and complications.
Is cisplatin better than carboplatin?
However, as has been previously observed, cisplatin was associated with more frequent hospitalizations, outpatient visits and complications. Our results support the widespread preferential use of carboplatin, but challenges the belief that cisplatin results in superior survival.
How many prospective trials have been conducted on radiotherapy with cisplatin?
Four prospective trials exploring radiotherapy with and without weekly low-dose cisplatin have been published. Two of them were conducted in the 1980s, one of which had a negative outcome, the third study provided insufficient information on toxicity, and the fourth trial had to be prematurely terminated due to poor accrual.
Does the use of cisplatin improve survival in non-squamous histology?
Similarly, the use of cisplatin was not associated with an improved survival among patients with non-squamous histology (HR 1.19, 95% CI 0.98-1.60, p=0.24), or patients receiving third generation regimens (HR 1.05, 95% CI 0.857-1.26, p=0.60).
Is there an alternative to cisplatin?
In the case of absolute interdiction of cisplatin, several alternative regimens incorporating carboplatin, 5-fluorouracil, cetuximab, and docetaxel are available.
How long is Erbitux infusion?
The recommended infusion period is 120 minutes. For the subsequent weekly doses, the recommended infusion period is 60 minutes. The infusion rate must not exceed 10 mg/min. Erbitux is contraindicated in patients with known severe (grade 3 or 4) hypersensitivity reactions to cetuximab.
Is chemotherapy used in conjunction with radiation therapy?
Brief Summary: RATIONALE: Drugs used in chemotherapy use different ways to stop tumor cells from dividing so they stop growing or die. Radiation therapy uses high-energy x-rays to damage tumor cells. Combining radiation therapy with chemotherapy may kill more tumor cells.
Is Erbitux chemotherapy?
ERBITUX with a type of chemotherapy called FOLFIRI (irinotecan, fluorouracil, leucovorin) was studied in a clinical trial of 1217 people with EGFR-expressing colorectal cancer that had spread (metastasized) to other parts of the body.
What is Erbitux used to treat?
Cetuximab is used to treat a certain type of cancer of the colon (large intestine) or rectum. This medication is also used to treat head and neck cancer. Cetuximab works by slowing or stopping the growth of cancer cells.
Which is harder on the body chemo or radiation?
Since radiation therapy is focused on one area of your body, you may experience fewer side effects than with chemotherapy. However, it may still affect healthy cells in your body.
Do tumors grow back after radiation?
Normal cells close to the cancer can also become damaged by radiation, but most recover and go back to working normally. If radiotherapy doesn't kill all of the cancer cells, they will regrow at some point in the future.
How can you tell if a tumor is shrinking?
How Do You Know You're in Remission? Tests look for cancer cells in your blood. Scans like X-rays and MRIs show if your tumor is smaller or if it's gone after surgery and isn't growing back. To qualify as remission, your tumor either doesn't grow back or stays the same size for a month after you finish treatments.
Head and Neck Cancer Alliance
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About this Community
The Head and Neck Cancer Alliance Support Community connects patients, families, friends and caregivers for support and inspiration. This community is sponsored by the Head and Neck Cancer Alliance, an Inspire trusted partner.
What percentage of people with cancer do not respond to treatment?
It also means that 30% of the people with this type and stage of cancer will not respond to the treatment or will have only a minimal response. Responses to therapy can be either complete or partial (these are defined according to the type of cancer and the specific protocol). Another consideration in determining which drugs to give is response ...
When was chemo first used?
Research : Chemotherapy was first introduced in the 1940's. For the next 20 years, it was considered an investigational treatment. In the last 30 years, chemotherapy information evolved and many more effective drugs have been developed.
What is the process of gathering chemotherapy information?
This process of gathering chemotherapy information has helped to establish specific protocols (types of drugs, doses of drugs and schedule of drugs) based on the type of cancer, stage of cancer, and other specifics about a person's cancer. Currently, most types of cancer have some standard protocols that help guide the doctors in selecting ...
Is chemotherapy toxic?
The Health of the Patient : Chemotherapy has toxicities. It must be given with care - even to healthy individuals. People who are extremely old and frail or who have other medical complications may not be able to tolerate certain chemotherapy protocols.
Is there a correct choice for chemotherapy?
There is no one correct choice in choosing chemotherapy. Each treatment protocol has advantages and disadvantages, and there may be more than one good option. In addition, treatment choices can change over time. A good chemotherapy treatment choice at one time may not be the choice at a later time. Finally, although doctors use the latest ...
Can you take chemo with one drug?
In some cases , the doctors may suggest a single drug rather than a "standard combination" of drugs. In other cases, the doctor and patient may decide not to pursue chemotherapy and, instead, focus on quality of life. There is no one correct choice in choosing chemotherapy.
Can you predict the outcome of chemotherapy?
Finally, although doctors use the latest chemotherapy research and the best response rates to select the best treatment protocols for their patients, there is no guarantee that an individual will achieve the desired response. It is impossible to predict the outcome of therapy for any individual. However, response rates have improved ...
Abstract
In locally advanced squamous cell carcinomas of the head and neck (LA-SCCHN), concurrent chemoradiotherapy is an integral part of multimodality management both in the adjuvant and in the definitive settings.
Introduction
In squamous cell carcinomas of the head and neck (SCCHN), the prevailing clinical presentation is a locoregionally advanced (LA) disease stage, for which patients are usually offered a multimodality approach involving chemoradiotherapy ( 1, 2 ).
Evidence from Controlled Trials
According to the inclusion criteria of our meta-analyses presented below, high-dose cisplatin was defined by a dose of 100 mg/m 2 given once every 3–4 weeks for a total of three doses if combined with conventional radiotherapy or two doses if combined with altered fractionation radiotherapy.
Evidence from a Meta-Analysis of 59 Trials
In two recent papers we analyzed aggregate data from altogether 59 prospective trials to take up the comparison between the two concurrent cisplatin regimens ( 8, 9 ). Consisting of three separate meta-analyses as explained below, our work offers further insight into the conundrum of low-dose vs. high-dose cisplatin.
Special Considerations
To continue on the subject of cumulative dose, we will mention several pivotal papers complemented by our own observations. In a systematic review, Strojan et al. constructed a model based on 6 phase III trials of definitive chemoradiotherapy.
Conclusions
The landscape of SCCHN has been undergoing important epidemiologic transitions, which have notable impact on patient outcome, disease classification, and will probably also diversify treatment options.
Author Contributions
PS and JV drafted the manuscript; KW conducted the statistical analysis; DA and DV contributed to writing of the manuscript; NK, MT, KP, and VN contributed to the conception and reviewed the manuscript.
What is the treatment for cancer?
Chemotherapy , often called "chemo," is a treatment with drugs that kill cancer cells directly. Chemotherapy attacks all rapidly-dividing cells within the body, effectively targeting fast-growing tumors. Chemotherapy can be used alone or in combination with surgery, radiation, or immunotherapy.
How does immunotherapy work?
Unlike chemotherapy, which acts directly on cancerous tumors, immunotherapy treats patients by acting on their immune system. Immunotherapy can boost the immune response in the body as well as teach the immune system how to identify and destroy cancer cells.
Why is it important to understand immunotherapy?
Although you should always speak to your health care professionals and seek their guidance about your treatment options, it’s also important for patients themselves to understand their treatments and how that could change their experiences and outcomes. Immunotherapy has the potential to help people affected by cancer —here’s why.
Does chemotherapy cause hair loss?
In order to destroy cancerous tumors, chemotherapy is intended to attack rapidly dividing cells within the body, which may include both cancerous and non-cancerous cells, such as hair follicles and the lining of the gut. These attacks on healthy cells may causes some of chemotherapy’s more well-known side effects, such as hair loss and nausea. In contrast, immunotherapy’s potential side effects usually result from an overstimulated or misdirected immune response, and can range from mild to moderate or severe and can become potentially life-threatening under certain circumstances.
Can immunotherapy cause side effects?
In contrast, immunotherapy’s potential side effects usually result from an overstimulated or misdirected immune response, and can range from mild to moderate or severe and can become potentially life-threatening under certain circumstances.
Is immunotherapy a first line of treatment?
Immunotherapy has already led to major advances in the treatment of many types of cancers, and has been approved as a first line of treatment for several. Its effectiveness has also been proven against types of cancer that have been historically resistant to chemotherapies and radiation treatments.
Can we make progress in cancer treatment without help?
We couldn’t make progress in the world of cancer treatment without help—contribute to continued breakthroughs in cancer research and treatment options by making a donation to CRI today. Updated December 20, 2019.
What are some herbal supplements that can disrupt the toxicity-efficacy balance of chemotherapy?
Echinacea, curcumin, St. John’s wort, valerian root, and allium (an extract of garlic) — all are examples of herbal supplements that can disrupt the toxicity-efficacy balance of chemotherapy.
What is chemo therapy?
Chemotherapeutic drugs are strong medications designed to target rapidly dividing cancer cells. If you or a loved one is undergoing chemotherapy, extra care should be taken to discuss the use of any over-the-counter (OTC) medications and herbal supplements with your health care team. “Drugs that a person normally takes without much concern can be ...
Does Prilosec work for GERD?
It works by decreasing the amount of acid produced in the stomach. “This means a patient taking Prilosec may get a lower dose of their chemotherapy than that targeted by their oncologist,” she said.
Does EGCG help with blood cancer?
A more specific herbal supplement-drug interaction is that of green tea extract (EGCG) and Velcade (bortezomib), a chemotherapeutic agent used to treat multiple myeloma, a type of blood cancer. “EGCG has been shown to reduce the anti-tumor effects of bortezomib,” she said.
Can you change the dose of chemo?
Changing the Dose. Another concern with OTC medications and herbal supplements is that they can change the effective dose of an oral chemotherapy by altering the drug’s absorption in the gastrointestinal tract. “Select oral chemotherapies require a certain stomach acidity to be appropriately absorbed," Saunders said.
