title: Carboplatin, continuous infusion fluorouracil and mid-cycle high-dose methotrexate as initial treatment in patients with locally advanced head and neck cancer. Hellenic Co-operative Oncology Group Study.
abstract: Forty-nine patients with locally advanced squamous cell carcinoma of the head and neck (SCCHN) were treated with 3 cycles of induction chemotherapy prior to definitive local treatment (surgery and/or radiation therapy). Chemotherapy consisted of carboplatin 300 mg/m2 on day 1, fluorouracil 1000 mg/m2 daily as a continuous infusion on days 1 to 5 and high-dose methotrexate 1.2 g/m2 with leucovorin rescue on day 14. After completing the induction chemotherapy, 9 patients (18%) achieved a complete remission (CR), 26 (54%) a partial remission (PR), 7 had stable disease and 7 a progression. The response rates increased to 53% CR and 18% PR following locoregional treatment. Survival at 12 months was 61% and its actuarial probability at 24 months 31%. Median time to progression was 14 months. Toxicity from chemotherapy was generally mild. Nausea was observed in 35%, vomiting in 26%, stomatitis in 57%, anemia in 22%, leukopenia in 36%, thrombocytopenia in 26% and diarrhea in 6% of the patients. In conclusion, the combination of carboplatin, 5-day continuous-infusion fluorouracil and mid-cycle high-dose methotrexate is a moderately effective, well tolerated regimen in patients with SCCHN but does not seem superior to the combination of carboplatin and fluorouracil only.
authors.affiliation: Department of Internal Medicine, AHEPA University Hospital, Thessaloniki, Greece.
authors.forename: G
authors.initials: G
authors.lastname: Fountzilas
authors.forename: P
authors.initials: P
authors.lastname: Kosmidis
authors.forename: P
authors.initials: P
authors.lastname: Makrantonakis
authors.forename: K S
authors.initials: KS
authors.lastname: Sridhar
authors.forename: K
authors.initials: K
authors.lastname: Banis
authors.forename: C
authors.initials: C
authors.lastname: Themelis
authors.forename: A
authors.initials: A
authors.lastname: Kalogera-Fountzila
authors.forename: V
authors.initials: V
authors.lastname: Avramidis
authors.forename: M
authors.initials: M
authors.lastname: Beer
authors.forename: K
authors.initials: K
authors.lastname: Sombolos
mesh_terms: D000368:Aged; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D016190:Carboplatin / Q000008:administration & dosage; D003131:Combined Modality Therapy; D004334:Drug Administration Schedule; D005260:Female; D005472:Fluorouracil / Q000008:administration & dosage; D006258:Head and Neck Neoplasms / Q000000981:diagnostic imaging / Q000188:drug therapy* / Q000401:mortality / Q000473:pathology; D006801:Humans; D008297:Male; D008727:Methotrexate / Q000008:administration & dosage; D008875:Middle Aged; D009367:Neoplasm Staging; D011859:Radiography; D011879:Radiotherapy Dosage; D012074:Remission Induction; D016019:Survival Analysis
chemical_list: D016190:Carboplatin; D005472:Fluorouracil; D008727:Methotrexate