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01-12-2008 | Original Article

Effectiveness of pharmacokinetic modulating chemotherapy combined with cisplatin as induction chemotherapy in resectable locally advanced head and neck cancer: phase II study

Authors: Peter Mu-Hsin Chang, Po-Min Chen, Pen-Yuan Chu, Ling-Wei Wang, Shyh-Kuan Tai, Tung-Lung Tsai, Jui-Lin Huang, Yi-Fen Wang, Shyue-Yih Chang, Muh-Hwa Yang

Published in: Cancer Chemotherapy and Pharmacology | Issue 1/2008

Abstract

Purpose

To test the efficacy and safety of pharmacokinetic modulating chemotherapy combined with cisplatin (PMC-cisplatin) as induction chemotherapy (ICT) before definitive treatment in patients with respectable locally advanced head and neck squamous cell carcinoma (HNSCC).

Patients and methods

Patients with stage III–IV resectable locally advanced HNSCC were enrolled. All eligible patients received PMC-cisplatin regimen as ICT containing intravenous leucovorin 250 mg/m² and 5-FU 600 mg/m² on day 1, oral tegafur–uracil (UFUR^®) 250 mg/m²/day on days 1–5, repeated every week for six courses. Cisplatin 100 mg/m²was given during the first and fourth courses of PMC. For ICT responders, concurrent chemoradiotherapy (CRT) with cisplatin/tegafur–uracil/70 Gy radiotherapy was performed. Salvage surgery plus postoperative CRT was given to ICT non-responders.

Results

The overall response rate of PMC-cisplatin as ICT was 76%, including a complete remission rate of 23%. The overall organ preservation rate of the multimodality treatment was 75%, with 97% in ICT responders. At a median follow-up of 25 months, 47% of the patients were still alive and disease-free. The superiority of disease-free survival was demonstrated in ICT responders. The 3-year overall survival rate was 67%. The toxicity of treatment was acceptable.

Conclusions

Application of PMC-cisplatin as the induction chemotherapy before definitive treatment provides a promising result in treatment response and survival of advanced HNSCC. This regimen is effective and safe, and further studies considering the combination of PMC with other chemotherapeutics such as taxanes to improve the clinical outcome of advanced HNSCC is warranted.

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Title: Effectiveness of pharmacokinetic modulating chemotherapy combined with cisplatin as induction chemotherapy in resectable locally advanced head and neck cancer: phase II study
Authors: Peter Mu-Hsin Chang
Po-Min Chen
Pen-Yuan Chu
Ling-Wei Wang
Shyh-Kuan Tai
Tung-Lung Tsai
Jui-Lin Huang
Yi-Fen Wang
Shyue-Yih Chang
Muh-Hwa Yang
Publication date: 01-12-2008
Publisher: Springer-Verlag
Published in: Cancer Chemotherapy and Pharmacology / Issue 1/2008
Print ISSN: 0344-5704
Electronic ISSN: 1432-0843
DOI: https://doi.org/10.1007/s00280-008-0702-1

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