title: Preoperative sequential chemotherapy in locally advanced squamous cell carcinoma of the head and neck.
abstract: BACKGROUND
  Induction chemotherapy may contribute to decreased local and distant recurrences in patients with locally advanced squamous cell carcinoma of the head and neck (SCCHN) resectable for cure.
  
  
  METHODS
  Patients with previously untreated locally advanced stage III-IV (N0-2, M0) SCCHN received a dose-dense sequential regimen combining cisplatin/5-fluorouracil followed by bleomycin/methotrexate/hydroxyurea. Induction chemotherapy was followed by locoregional surgery and/or radiation therapy.
  
  
  RESULTS
  Among 37 patients, 23 (62%) had T4 primary tumors. Grade 3 to 4 asymptomatic hematologic toxicity occurred in less than 15% of patients. Nonhematologic toxicities were limited to grade 1 to 2 in less than 20% of patients. In the overall cohort (intent-to-treat; n = 35), 24 (68.5%) of 35 patients had objective clinical responses, including nine complete responses (25.7%). Fifty-seven percent of patients were free of disease at 2.5 years.
  
  
  CONCLUSIONS
  Sequential induction chemotherapy is feasible and active in patients with locally advanced head and neck cancers and may further include recent compounds such as taxanes.
authors.affiliation: Department of Head and Neck Surgery, Department of Head and Neck Surgery, Gustave-Roussy Institute, 39 rue Camille-Desmoulins, 94805 Villejuif Cedex, France.
authors.forename: Sandrine
authors.initials: S
authors.lastname: Faivre
authors.forename: Adina
authors.initials: A
authors.lastname: Marti
authors.forename: Olivier
authors.initials: O
authors.lastname: Rixe
authors.forename: François
authors.initials: F
authors.lastname: Janot
authors.forename: Morbize
authors.initials: M
authors.lastname: Julieron
authors.forename: Michel
authors.initials: M
authors.lastname: Gatineau
authors.forename: Stéphane
authors.initials: S
authors.lastname: Temam
authors.forename: Jean-Pierre
authors.initials: JP
authors.lastname: Armand
authors.forename: Christian
authors.initials: C
authors.lastname: Domenge
authors.forename: Bernard
authors.initials: B
authors.lastname: Luboinski
authors.forename: Eric
authors.initials: E
authors.lastname: Raymond
mesh_terms: D000328:Adult; D000368:Aged; D000903:Antibiotics, Antineoplastic / Q000008:administration & dosage; D000964:Antimetabolites, Antineoplastic / Q000008:administration & dosage; D000970:Antineoplastic Agents / Q000008:administration & dosage; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D001761:Bleomycin / Q000008:administration & dosage; D002294:Carcinoma, Squamous Cell / Q000188:drug therapy* / Q000473:pathology / Q000601:surgery; D002945:Cisplatin / Q000008:administration & dosage; D015331:Cohort Studies; D018572:Disease-Free Survival; D005240:Feasibility Studies; D005260:Female; D005472:Fluorouracil / Q000008:administration & dosage; D006258:Head and Neck Neoplasms / Q000188:drug therapy* / Q000473:pathology / Q000601:surgery; D006801:Humans; D006918:Hydroxyurea / Q000008:administration & dosage; D008297:Male; D008727:Methotrexate / Q000008:administration & dosage; D008875:Middle Aged; D020360:Neoadjuvant Therapy; D009364:Neoplasm Recurrence, Local / Q000517:prevention & control; D009367:Neoplasm Staging; D012074:Remission Induction
chemical_list: D000903:Antibiotics, Antineoplastic; D000964:Antimetabolites, Antineoplastic; D000970:Antineoplastic Agents; D001761:Bleomycin; D002945:Cisplatin; D005472:Fluorouracil; D006918:Hydroxyurea; D008727:Methotrexate