title: Weekly 5-fluorouracil and folinic acid plus escalating doses of cisplatin with glutathione protection in patients with advanced head and neck cancer.
abstract: Twenty-two patients with advanced head and neck carcinoma were treated with 5FU 400 mg-2 m-1 week and folinic acid 500 mg m-2 week-1 plus CDDP in escalating doses from 20 to 40 mg m-2 week-1 without forced diuresis. Reduced glutathione at the dose of 1.5 g m-2 was employed to protect patients from CDDP-related nephrotoxicity. The aims of the study were: a) to evaluate the therapeutic efficacy of this schedule, and b) to evaluate reduced glutathione as uroprotector. Out of 20 evaluable patients 14 (70%) had a major objective response. A CR with a mean duration of 9.0+ months was achieved in 15% of the patients, a PR of 5.8+ months in 55% of the patients, while 3 patients had stable disease and 4 progressed. It was possible to escalate CDDP up to 35 mg m-2 week-1, but at the dose of CDDP 40 mg m-2 week-1 the occurrence of grade 2 renal toxicity provoked a severe reduction of dose-intensity. Overall, this treatment has been very well tolerated by most patients with few cases of grade 3 gastrointestinal or hematological toxicity. In conclusion, the schedule seems effective and may be safely given to patients with advanced head and neck cancer on outpatient basis. Reduced glutathione seems to be able to reduce, at least partially, CDDP-related nephrotoxicity permitting the delivery of higher CDDP doses.
authors.affiliation: Chair of Chemotherapy, University of Palermo, Italy.
authors.forename: V
authors.initials: V
authors.lastname: Gebbia
authors.forename: R
authors.initials: R
authors.lastname: Valenza
authors.forename: A
authors.initials: A
authors.lastname: Testa
authors.forename: G
authors.initials: G
authors.lastname: Zerillo
authors.forename: S
authors.initials: S
authors.lastname: Restivo
authors.forename: G
authors.initials: G
authors.lastname: Cupido
authors.forename: F
authors.initials: F
authors.lastname: Ingria
authors.forename: G
authors.initials: G
authors.lastname: Spadafora
authors.forename: C
authors.initials: C
authors.lastname: Barbaccia
authors.forename: G
authors.initials: G
authors.lastname: Cannata
mesh_terms: D000368:Aged; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D002945:Cisplatin / Q000008:administration & dosage / Q000009:adverse effects; D004305:Dose-Response Relationship, Drug; D004334:Drug Administration Schedule; D005260:Female; D005472:Fluorouracil / Q000008:administration & dosage; D005978:Glutathione / Q000627:therapeutic use*; D006258:Head and Neck Neoplasms / Q000188:drug therapy*; D006801:Humans; D007674:Kidney Diseases / Q000139:chemically induced / Q000517:prevention & control; D002955:Leucovorin / Q000008:administration & dosage; D008297:Male; D008875:Middle Aged
chemical_list: D005978:Glutathione; D002945:Cisplatin; D002955:Leucovorin; D005472:Fluorouracil