Abstract
The combination of cisplatin (CDDP 100 mg/m2 on day 1) and 5-fluorouracil (5-FU 1,000 mg/m2 continuous intravenous (i.v.) infusion days 1-5) is the most widely used chemotherapy regimen for the treatment of advanced head and neck carcinomas, with a response rate of 70-90% but with a survival and a duration of response which are not impressive. Most patients relapse in < or = 2 years and die of cancer. We evaluated the activity of a CDDP (90 mg/m2 on day 1), 5-FU (900 mg/m2/120 h continuous i.v. infusion from day 1), and mitomycin C (MMC 6 mg/m2 on day 1) regimen in advanced or recurrent head and neck squamous cell carcinoma (HNSCC). Fifty-six patients were treated and evaluated for response and toxicity: 5 (9%) complete responses (CR) and 36 (64%) partial responses, (PR) were observed (response rate 73%). The median duration of response was 12 months, and median survival was 15 months. At a median follow-up of 14 months, the estimated overall survival at 1 year was 65%; at 2 years, it was 35%. Grade 3-4 toxicity was noted in 14 patients, mostly hematologic; overall toxicity required a dose-intensity decrease in 20.2% of all cycles. No treatment-related deaths occurred. The regimen showed a good response rate and an encouraging median duration of response with a good tolerability profile.
MeSH terms
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Adult
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Aged
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Antibiotics, Antineoplastic / administration & dosage*
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Antibiotics, Antineoplastic / adverse effects
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Antimetabolites, Antineoplastic / administration & dosage*
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Antimetabolites, Antineoplastic / adverse effects
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Antineoplastic Agents / administration & dosage*
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Antineoplastic Agents / adverse effects
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Antineoplastic Combined Chemotherapy Protocols / administration & dosage
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Antineoplastic Combined Chemotherapy Protocols / adverse effects
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Antineoplastic Combined Chemotherapy Protocols / therapeutic use*
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Carcinoma, Squamous Cell / drug therapy*
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Carcinoma, Squamous Cell / pathology
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Cause of Death
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Cisplatin / administration & dosage*
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Cisplatin / adverse effects
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Combined Modality Therapy
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Female
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Fluorouracil / administration & dosage*
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Fluorouracil / adverse effects
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Follow-Up Studies
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Head and Neck Neoplasms / drug therapy*
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Head and Neck Neoplasms / pathology
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Humans
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Infusions, Intravenous
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Leukopenia / chemically induced
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Male
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Middle Aged
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Mitomycin / administration & dosage*
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Mitomycin / adverse effects
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Mucous Membrane / drug effects
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Nausea / chemically induced
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Neoplasm Recurrence, Local / drug therapy*
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Neoplasm Staging
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Neutropenia / chemically induced
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Remission Induction
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Survival Rate
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Thrombocytopenia / chemically induced
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Vomiting / chemically induced
Substances
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Antibiotics, Antineoplastic
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Antimetabolites, Antineoplastic
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Antineoplastic Agents
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Mitomycin
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Cisplatin
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Fluorouracil