title: Two- vs three-drug combination chemotherapy in advanced or recurrent head and neck cancer: a single institution experience of 361 patients.
abstract: Head and neck squamous cancer is a major concern in India. The proportion of advanced cases is significantly high, and these patients have dismal survival prospects despite aggressive therapy. Often surgical resection and/or radiotherapy are not feasible in these patients. Hence, we decided to explore the option of neoadjuvant chemotherapy using effective agents like ifosfamide and paclitaxel in combination with cisplatin in these patients. A total of 361 patients were evaluable at the end of study. Of these, 207 had received ifosfamide and cisplatin and 154 had received taxanes (paclitaxel or docetaxel) in addition to ifosfamide and cisplatin. The ifosfamide-cisplatin group had an overall response rate of 66.67% (CR, 16.42%; PR, 50.24%) and the median duration of response was 5.5 mo; whereas the group in which taxanes were added, showed an overall response rate of 73.37% (CR, 7.79%; PR, 65.58%) with a median duration of response of 10 mo. The toxicity in both the groups was acceptable and there was no mortality. We conclude that taxane-based combinations have a significant activity in advanced head and neck squamous cancer and warrant further studies.
authors.affiliation: Department of Medical and Surgical Oncology, Tata Memorial Hospital, Parel, Mumbai 400012, India. drvrpai@rediffmail.com
authors.forename: V R
authors.initials: VR
authors.lastname: Pai
authors.forename: A T
authors.initials: AT
authors.lastname: Mazumdar
authors.forename: C D
authors.initials: CD
authors.lastname: Deshmukh
authors.forename: A V
authors.initials: AV
authors.lastname: Bakshi
authors.forename: D M
authors.initials: DM
authors.lastname: Parikh
authors.forename: P M
authors.initials: PM
authors.lastname: Parikh
authors.forename: R C
authors.initials: RC
authors.lastname: Mistry
authors.forename: K A
authors.initials: KA
authors.lastname: Pathak
authors.forename: A K
authors.initials: AK
authors.lastname: D'Cruz
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000009:adverse effects / Q000627:therapeutic use*; D002945:Cisplatin / Q000008:administration & dosage; D005260:Female; D006258:Head and Neck Neoplasms / Q000188:drug therapy* / Q000473:pathology; D006801:Humans; D007069:Ifosfamide / Q000008:administration & dosage; D008297:Male; D008875:Middle Aged; D020360:Neoadjuvant Therapy; D009364:Neoplasm Recurrence, Local / Q000188:drug therapy* / Q000473:pathology; D011379:Prognosis; D012189:Retrospective Studies; D043823:Taxoids / Q000008:administration & dosage
chemical_list: D043823:Taxoids; D002945:Cisplatin; D007069:Ifosfamide