[The role of taxanes for head and neck cancer].
Taxanes are a highly active anti-cancer drug for squamous cell carcinoma of the head and neck (SCCHN). When used as a single agent, the overall response rates were between 20-40%. In Japan, the phase I study revealed that the maximum tolerated dose of the docetaxel was 70-90 mg/m2 and the recommended dose was 60 mg/m2. The main toxicity was neutropenia. Docetaxel administered in combination with cisplatin has demonstrated promising response rates ranging from 40-70% for recurrent or metastatic SCCHN. Its effect is similar to that of a cisplatin plus 5-fluorouracil regimen. A three-drug combination with docetaxel, cisplatin and 5-fluorouracil has been tested. The preliminary results with three drugs in combination seems superior to a two-drug combination. However, the final conclusions regarding theses drug combinations will be given by the results of an ongoing EORTC #249 71 study. Weekly docetaxel with concurrent chemoradiotherapy is feasible and active for locally unresectable SCCHN. Cisplatin plus 5-fluorouracil based concurrent chemoradiation regimens have demonstrated improved survival compared with conventional radiotherapy. Docetaxel including regimens showed efficacy with mucositis as the major acute toxicity and a swallowing problem as the chronic toxicity. Thus, the three-drug combination as the chemoradiation setting seems to be toxic for Japanese patients. A new intensive supporting care approach focused on mucositis is warranted.
Kohno
Naoyuki
N
Dept. of Otolaryngology, Kyorin University School of Medicine, Shinkawa, Mitaka Tokyo, Japan.
D000971:Antineoplastic Combined Chemotherapy Protocols / Q000009:adverse effects / Q000627:therapeutic use*; D002294:Carcinoma, Squamous Cell / Q000188:drug therapy* / Q000532:radiotherapy; D002945:Cisplatin / Q000008:administration & dosage; D017321:Clinical Trials, Phase I as Topic; D017322:Clinical Trials, Phase II as Topic; D003131:Combined Modality Therapy; D000077143:Docetaxel; D004334:Drug Administration Schedule; D005472:Fluorouracil / Q000008:administration & dosage; D006258:Head and Neck Neoplasms / Q000188:drug therapy* / Q000532:radiotherapy; D006801:Humans; D009503:Neutropenia / Q000139:chemically induced; D043823:Taxoids / Q000008:administration & dosage*
D043823:Taxoids; D000077143:Docetaxel; D002945:Cisplatin; D005472:Fluorouracil