Biweekly paclitaxel, cisplatin, tegafur, and leucovorin as neoadjuvant chemotherapy for unresectable squamous cell carcinoma of the head and neck

Abstract

BACKGROUNDThe goal of the current study was to evaluate the efficacy and toxicity of paclitaxel, cisplatin (P), tegafur (T), and leucovorin (L) as a neoadjuvant chemotherapy (CT) for patients with advanced, unresectable squamous cell carcinoma of the head and neck.METHODSFrom November 1999 to January 2001, 21 consecutive patients (Stage IV, 100%; T4, 86%; and N3, 41%) were treated with paclitaxel‐PTL (Day 1: paclitaxel, 120 mg/m2 intravenous infusion for 3 hours; Day 1: P, 50 mg/m2; T, 800 mg; and L, 60 mg orally daily over a 14‐day cycle). Evaluation after three cycles led to CT termination if primary tumor responses were less than partial responses. Otherwise, paclitaxel‐PTL was continued for up to six cycles before commencement of locoregional therapy.RESULTSCT responses were analyzed on an intent‐to‐treat basis. Response rates (RR) for the primary tumors were 81% (17 of 21), with 28.6% (6 of 21) showing a complete response (CR). RR and CR rates for the neck lymph nodes were 85.3% (15 of 18) and 22% (4 of 18), respectively. The combined RR for primary tumors and neck lymph nodes was 81% (95% confidence interval, 62.9–99.3%) with a CR rate of 19%. Grade 3/4 toxicities according to World Health Organization criteria included leukopenia, 19.0%; emesis, 9.5%; asthenia, 9.5%; mucositis, 4.8%; and neuropathy, 4.8%. Both the overall and disease‐free survival rates were 14.3% (3 of 21), with a median follow‐up of 41 months.CONCLUSIONSThe relatively low toxicities and encouraging response rates demonstrated in the current study suggested that paclitaxel‐PTL merits future trials in the setting of resectable tumors with more favorable characteristics. Cancer 2004. © 2004 American Cancer Society.

Association between multidisciplinary team care approach and survival rates in patients with oral cavity squamous cell carcinoma

“…The radiation field included the entire tumor bed area (with 1‐ to 2‐cm margins) as well as the regional lymphatics. Concomitant chemoradiotherapy (CRT; 66 Gy) with cisplatin‐based regimens was administered to patients with extracapsular spread (ECS), multiple lymph node metastases, positive margins, or ≥3 minor risk factors (ie, the above‐mentioned minor risk factors plus pT4) . The chemotherapy regimen consisted of intravenous cisplatin 50 mg/m 2 biweekly plus daily oral tegafur 800 mg and leucovorin 60 mg, cisplatin 40 mg/m 2 weekly, or cisplatin 100 mg/m 2 every 3 weeks …”

“…[13][14][15] The chemotherapy regimen consisted of intravenous cisplatin 50 mg/ m 2 biweekly plus daily oral tegafur 800 mg and leucovorin 60 mg, cisplatin 40 mg/m 2 weekly, or cisplatin 100 mg/m 2 every 3 weeks. 15…”

Correlated factors of acute oral mucosal and skin reaction induced by radiotherapy in hypopharyngeal carcinoma

“…Chemotherapy and radiotherapy can complement each other and exert synergistic action on treatment of tumor because RT is significant on local control while chemotherapy is particularly important to systemic metastasis [12,13] . However, the normal tissues couldn't be spared totally when chemo-therapeutic drugs destroying tumor cells.…”

Missed radiation therapy sessions in first three weeks predict distant metastasis and less favorable outcomes in surgically treated patients with oral cavity squamous cell carcinoma

“…Concurrent chemotherapy was offered to patients harboring adverse prognostic factors [ 17 ]. Cisplatin – generally administered as a single dose of 100 mg/m 2 every 3 weeks or at a weekly dose of 40 mg/m 2 – was the most commonly used chemotherapy agent [ 19 , 20 ].…”