title: Sequential administration of methotrexate, cisplatin, and 5-fluorouracil in multimodal therapy for locally advanced head and neck cancer.
abstract: Thirty-eight previously untreated patients with locally advanced head and neck cancer received three cycles of induction chemotherapy with methotrexate (120 mg/m2) followed by cisplatin (100 mg/m2) and a 5-day continuous infusion of 5-fluorouracil (1,000 mg/m2 per day). The response rate in 34 evaluable patients was 94%, with a complete response rate of 26%. Thirty-one patients underwent local therapy following induction chemotherapy, and 25 (81%) were rendered free of disease: 14 of 15 treated with surgery and radiotherapy and 11 of 16 treated with radiotherapy alone. At a median follow-up of 11 months, 8 patients have relapsed while the remaining 17 patients continue free of disease. The dose-limiting toxicity of chemotherapy was mucositis resulting in reduction of the 5-fluorouracil dose in 28 patients. This regimen is highly effective in inducing responses in patients with locally advanced head and neck cancer; 81% of the patients who complete local therapy are rendered free of disease with this multimodal approach. Due to short follow-up, the relapse rate, overall survival, and disease-free survival cannot yet be determined.
authors.affiliation: Department of Medicine, University of Chicago, IL.
authors.forename: E E
authors.initials: EE
authors.lastname: Vokes
authors.forename: W J
authors.initials: WJ
authors.lastname: Moran
authors.forename: A M
authors.initials: AM
authors.lastname: Awan
authors.forename: R L
authors.initials: RL
authors.lastname: Schilsky
authors.forename: M
authors.initials: M
authors.lastname: Goldman
authors.forename: H G
authors.initials: HG
authors.lastname: Sutton
authors.forename: R R
authors.initials: RR
authors.lastname: Weichselbaum
authors.forename: W R
authors.initials: WR
authors.lastname: Panje
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000009:adverse effects / Q000627:therapeutic use*; D002945:Cisplatin / Q000008:administration & dosage; D003131:Combined Modality Therapy; D004334:Drug Administration Schedule; D005260:Female; D005472:Fluorouracil / Q000008:administration & dosage; D006258:Head and Neck Neoplasms / Q000401:mortality / Q000628:therapy*; D006801:Humans; D008297:Male; D008727:Methotrexate / Q000008:administration & dosage; D008875:Middle Aged
chemical_list: D002945:Cisplatin; D005472:Fluorouracil; D008727:Methotrexate