1. Preoperative sequential chemotherapy in locally advanced squamous cell carcinoma of the head and neck.
- Author
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Faivre S, Marti A, Rixe O, Janot F, Julieron M, Gatineau M, Temam S, Armand JP, Domenge C, Luboinski B, and Raymond E
- Subjects
- Adult, Aged, Antibiotics, Antineoplastic administration & dosage, Antimetabolites, Antineoplastic administration & dosage, Antineoplastic Agents administration & dosage, Bleomycin administration & dosage, Carcinoma, Squamous Cell pathology, Carcinoma, Squamous Cell surgery, Cisplatin administration & dosage, Cohort Studies, Disease-Free Survival, Feasibility Studies, Female, Fluorouracil administration & dosage, Head and Neck Neoplasms pathology, Head and Neck Neoplasms surgery, Humans, Hydroxyurea administration & dosage, Male, Methotrexate administration & dosage, Middle Aged, Neoadjuvant Therapy, Neoplasm Recurrence, Local prevention & control, Neoplasm Staging, Remission Induction, Antineoplastic Combined Chemotherapy Protocols therapeutic use, Carcinoma, Squamous Cell drug therapy, Head and Neck Neoplasms drug therapy
- 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.
- Published
- 2005
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