{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,4]],"date-time":"2026-10-04T00:37:58Z","timestamp":1791074278603,"version":"4.1.0"},"reference-count":16,"publisher":"SAGE Publications","issue":"1","license":[{"start":{"date-parts":[[2003,1,1]],"date-time":"2003-01-01T00:00:00Z","timestamp":1041379200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Tumori"],"published-print":{"date-parts":[[2003,1]]},"abstract":"<jats:sec>\n                    <jats:title>Background and Aims<\/jats:title>\n                    <jats:p>To evaluate the feasibility in clinical practice of alternating chemo-radiotherapy in locally advanced head and neck cancer patients.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Patients and Methods<\/jats:title>\n                    <jats:p>From August 1993 to April 1998 at the Division of Medical Oncology of Parma, 48 consecutive patients were observed, and 38 (79%) started the Merlano chemo-radiotherapy. The characteristics of the patients were: males (32, 84%); median age, 57 years; PS &lt;2 (32, 84%). The primary sites were the oropharynx (18, 47%), oral cavity (8, 21%), hypopharynx (7, 19%), larynx (5, 13%); stage IV disease was present in 29 (76%) patients. Twenty-five (66%) patients were married, and 24 (63%) resided outside of the city.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>The compliance was very low: 21 patients (55%) performed all the programmed cycles of chemotherapy, whereas only 5 patients (13%) performed the chemo-radiotherapy at full doses without any delay. The objective responses were 3 (8%) complete and 21 (55%) complete plus partial responses. Failures were 2 (5%) stable disease and 2 (5%) progressive disease, and the response was not assessable in 10 (26%). The median duration of the response was 8 months. The median overall survival and the time to progression were 18 and 13 months, respectively; the 5-year overall and relapse-free survival were 36% and 26%, respectively. Nine (24%) patients were still alive as of August 30, 2001, 8 (21%) of them without progression. Twenty-six patients (68%) died with a local-regional relapse. One patient (3%) died for a second cancer. Grade 3\u20134 hematologic toxicity was leukopenia (n = 25, 66%) and thrombocytopenia (n = 9, 24%); grade 3\u20134 non-hematologic toxicity was diarrhea (n = 3, 8%) and mucositis (n = 2, 5%). Two patients (5%) died for intestinal infarction and perforation possibly related to treatment.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Compliance to the chemo-radiotherapy was very poor. The response rate was lower than that reported in clinical trials, whereas overall survival was comparable. The alternating chemo-radiotherapy is a very complex treatment that cannot be easily applied in clinical practice; a careful selection of patients is mandatory not only considering oncologic and medical criteria, but also the level of awareness of the patient and his family.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/030089160308900105","type":"journal-article","created":{"date-parts":[[2018,4,23]],"date-time":"2018-04-23T11:22:43Z","timestamp":1524482563000},"page":"20-25","source":"Crossref","is-referenced-by-count":6,"title":["Compliance and Outcomes in Locally Advanced Head and Neck Cancer Patients Treated with Alternating Chemoradiotherapy in Clinical Practice"],"prefix":"10.1177","volume":"89","author":[{"given":"Vittorio","family":"Franciosi","sequence":"first","affiliation":[{"name":"Division of Medical Oncology, Hospital of Parma;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marco","family":"Fumagalli","sequence":"additional","affiliation":[{"name":"Radiotherapy Unit, University, Hospital of Parma;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Luciana","family":"Biscari","sequence":"additional","affiliation":[{"name":"Division of Medical Oncology, Hospital of Parma;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Roberto","family":"Martinelli","sequence":"additional","affiliation":[{"name":"Radiotherapy Unit, University, Hospital of Parma;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Teore","family":"Ferri","sequence":"additional","affiliation":[{"name":"ENT Department, University of Parma, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mariangela","family":"Bella","sequence":"additional","affiliation":[{"name":"Division of Medical Oncology, Hospital of Parma;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Guido","family":"Ceci","sequence":"additional","affiliation":[{"name":"Division of Medical Oncology, Hospital of Parma;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vincenzo","family":"Delisi","sequence":"additional","affiliation":[{"name":"Division of Medical Oncology, Hospital of Parma;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Beatrice","family":"Di Blasio","sequence":"additional","affiliation":[{"name":"Division of Medical Oncology, Hospital of Parma;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Francesco","family":"Leonardi","sequence":"additional","affiliation":[{"name":"Division of Medical Oncology, Hospital of Parma;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maria","family":"Michiara","sequence":"additional","affiliation":[{"name":"Division of Medical Oncology, Hospital of Parma;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Francesca","family":"Pucci","sequence":"additional","affiliation":[{"name":"Division of Medical Oncology, Hospital of Parma;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Giovanna","family":"Vasini","sequence":"additional","affiliation":[{"name":"Division of Medical Oncology, Hospital of Parma;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Roberta","family":"Camisa","sequence":"additional","affiliation":[{"name":"Division of Medical Oncology, Hospital of Parma;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stefano","family":"Cascinu","sequence":"additional","affiliation":[{"name":"Division of Medical Oncology, Hospital of Parma;"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2003,1,1]]},"reference":[{"key":"bibr1-030089160308900105","first-page":"386A","volume":"171","author":"Bourhis 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