Phase I Study of Cisplatin And ZD1839 (IRESSA®) in Combination With Concomitant Re-Irradiation in Patients With Loco-Regional Recurrent Squamous Cell Cancer of the Head and Neck
- Patients must have pathologically confirmed recurrence (reappearance
of previously cleared) squamous cell cancer primary in the upper aerodigestive tract or a
second squamous cell primary (excluding nasopharynx or salivary gland tumors). Patients
may have experienced more than one recurrence as long as the first recurrence occurred
greater than or equal to 6 months following the end of the prior RT.
- The recurrence or second primary must have defined bi- or uni-dimensional
- Recurrence or second primary must be confined to the head and neck above the
clavicles (loco-regional recurrence).
- The patient must not be a candidate for complete surgical resection. The previous
irradiation must not exceed a maximum of 75 Gy.
- The entire tumor volume must be included in a treatment field that limits the total
spinal cord dose to 50 Gy (prior RT and anticipated RT).
- Patients must be at least 6 months from prior radiation therapy.
- Patients may have received prior chemotherapy as a component of their primary
treatment, but not for recurrent disease.
- Zubrod performance status 0-1.
- Granulocytes greater than or equal to 1500/mm3, platelets greater than or equal to
100,000/mm3, serum bilirubin less than or equal to 1.5 mg/dl, creatinine less than or
equal to 1.5 mg/dl within 2 weeks prior to registration.
- LFT's less than or equal to 2 x normal (SGOT/SGPT/Alkaline Phosphatase). If greater
than 2 x normal, liver ultrasound or CT is required to exclude metastases. If
negative for metastases, patients are eligible.
- Must be able to submit previous radiation records, including simulation and portal
films, in order to assure that cord tolerance is not exceeded.
- Patients must sign a study-specific informed consent form prior to study entry.
Exclusion Criteria:- Primary in the nasopharynx or the salivary gland.
- Intercurrent medical illnesses which would impair patient tolerance to therapy or
- A history of allergic reactions attributed to compounds of similar chemical or
biologic composition to ZD1839 or other agents used in study.
- Pregnant and nursing women are excluded because of the potential teratogenic effects
and potential unknown effects on nursing newborns.