Induction paclitaxel and carboplatin for patients with head and neck carcinoma

Abstract

Induction paclitaxel and carboplatin was well tolerated. The response rate was encouraging considering most patients were Stage IV. Chemotherapy response identified a group with improved prognosis. Organ preservation was possible at all anatomic sites.

Phase II evaluation of paclitaxel in combination with carboplatin in advanced head and neck carcinoma

“…Dunphy et al, 9 Stathopoulos et al, 14 and Fountzilas et al 8 reported response rates of 54%, 39%, and 23%, respectively. Of note, however, the report by Dunphy et al 9 included patients with newly diagnosed, previously untreated disease and reported a 60% response rate for patients with nasopharyngeal carcinoma, a highly chemotherapy-sensitive malignancy, but only a 23% response rate for other primary SCCHN.…”

“…Three patients in this group suffered treatment-related deaths due to sepsis as a direct result of febrile neutropenia and likely bleeding due to thrombocytopenia. In another Phase I and II studies that have used carboplatin and paclitaxel, Dunphy et al 9 reported a 67% incidence of neutropenia and 1 patient with death due to neutropenic sepsis. Stathopoulos et al 14 reported 17% incidence of neutropenic fevers.…”

“…Common toxicities of paclitaxel and carboplatin such as myalgias/arthralgias or paresthesias were of a mild nature and did not require dose adjustments or treatment delays. Of the reported studies using the combination paclitaxel and carboplatin, the highest incidence of Grade 3-4 neurotoxicity was reported in Dunphy et al 9 at 17% whereas all other studies reported less than 2% incidence.…”

“…6 Carboplatin a less nephrotoxic and emetogenic platinum analog, has been used in head and neck carcinoma 7 and, in combination with paclitaxel, has significant activity against inoperable SCCHN with reported overall response rates from 23% to 32%. 8,9 In an attempt to improve prior survival rates, we investigated the use of paclitaxel and carboplatin in a limited Phase II study in recurrent or metastatic SC-CHN. The objectives of this Phase II study were to evaluate tumor response to the combination of paclitaxel and carboplatin, time to progression, overall survival in patients treated with this regimen, and qualitative and quantitative toxicities of this regimen.…”

Investigation of ototoxic effects of Taxol on a mice model

“…Currently taxol combined with a platinum agent is considered to be the one of the most promising adjuvant chemotherapy regimens in advanced ovarian cancer [2]. It has also been reported to be effective against various carcinomas including non-small cell carcinoma of the lung [3], breast [4] and head and neck cancer [5] in adult population as well as the pediatric age group. Like the other antineoplastic agents, taxol also has many side effects of which neutropenia and peripheral neuropathy are the major dose-limiting ones [6].…”