title: Ifosfamide in advanced epidermoid head and neck cancer.
abstract: A total of 37 men with epidermoid head and neck cancer whose disease had recurred following primary treatment (surgery and/or radiotherapy) received first-line chemotherapy with ifosfamide at i.v. doses of 3 g/m2 given daily on 3 consecutive days in combination with mesna (600 mg/m2 x 3 oral daily doses on days 1-3) every 3 weeks. In all, 7 patients showed a partial response and 2 patients achieved a complete response, for an overall objective response rate of 26% (9 of 35 eligible patients; 95% confidence interval, 12.5%-43%). Excluding the 5 early nontoxic deaths observed during the first 3 weeks of therapy, the objective response rate was 30% (9 of 30 patients; 95% confidence interval, 15%-49.5%). Responses were seen in lung metastases (2 patients), lymph nodes (2 patients), skin (3 patients), and cases of local recurrence (5 patients). The median duration of responses was 3 months (range, 2-5 months). The main side effects of ifosfamide were alopecia (83% of patients), emesis (80%), granulocytopenia (23%), and mild mucositis (20%). Two poor-risk patients suffered severe CNS complications that were probably related to treatment. Three patients died due to chemotherapy-related complications (2 patients with CNS toxicity and 1 patient with granulocytopenic sepsis). In conclusion, ifosfamide appears to be an active drug in epidermoid head and neck cancer and merits further evaluation in this disease.
authors.affiliation: Servicio de Oncología Médica, Hospital Universitario San Carlos, Madrid, Spain.
authors.forename: M
authors.initials: M
authors.lastname: Martín
authors.forename: E
authors.initials: E
authors.lastname: Diaz-Rubio
authors.forename: J L
authors.initials: JL
authors.lastname: González Larriba
authors.forename: A
authors.initials: A
authors.lastname: Casado
authors.forename: J
authors.initials: J
authors.lastname: Sastre
authors.forename: J M
authors.initials: JM
authors.lastname: López-Vega
authors.forename: J
authors.initials: J
authors.lastname: Almenarez
authors.forename: S
authors.initials: S
authors.lastname: Dominguez
mesh_terms: D000328:Adult; D000368:Aged; D000505:Alopecia / Q000139:chemically induced; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D002294:Carcinoma, Squamous Cell / Q000188:drug therapy*; D006258:Head and Neck Neoplasms / Q000188:drug therapy*; D006801:Humans; D007069:Ifosfamide / Q000008:administration & dosage / Q000009:adverse effects; D008297:Male; D015080:Mesna / Q000008:administration & dosage; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000188:drug therapy*
chemical_list: D015080:Mesna; D007069:Ifosfamide