The promising role of safe initial non-cisplatin-containing combination chemotherapy in nasopharyngeal tumors.
Twenty patients with previously untreated nasopharyngeal tumors received, as initial treatment, two courses of Schedule A chemotherapy including vincristine, 5-fluorouracil, bleomycin, hydrocortisone, methotrexate, and a folinic acid rescue, prior to definitive radiotherapy. Thirteen patients had Stage IV and seven had Stage III tumors, with nodal involvement in 18 patients (90%). Response to two courses of Schedule A chemotherapy was assessed on day 28, and overall, 18 patients responded. Side effects were minimal. Following radiotherapy 17 patients achieved a clinical complete remission. Durations of response ranged from 6 to 95+ months (median 40 months) and of survival from 8 to 95+ months (median 53 months). This chemotherapy protocol should be more widely evaluated as initial treatment in nasopharyngeal carcinomas since the 90% chemotherapy response rate and, after radiotherapy, 85% clinical complete remission rate was accomplished with minimal toxicity and interference with patients' quality of life and resulted in median overall survival figures of approximately four years.
Cellular Chemotherapy Laboratory, Imperial Cancer Research Fund, London, United Kingdom.
B T
BT
Hill
L A
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Price
K D
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MacRae
D000328:Adult; D000368:Aged; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000009:adverse effects / Q000627:therapeutic use*; D003131:Combined Modality Therapy; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D009303:Nasopharyngeal Neoplasms / Q000188:drug therapy*