Background:
@EN The prognosis for patients with locally advanced head and neck cancer remains poor. In recent years. attempts at improving the poor survival rates have frequently focused on the initial use of chemotherapy followed by subsequent standard
local
therapy with surgery and radiation.
@ES Methods:
@EN Twenty-seven patients with previously untreated, locally advanced (stage Ⅲor Ⅳ) head and neck cancer were treated with 2 or 3 cycles of combination chemotherapy consisting of 5-fluorouracil infusion and cisplatin followed by operation or
radiotherapy between january, 1988 and March, 1994.
@ES Results:
@EN 1) After the neoadjuvant FP chemotherapy, sixteen of 27 patients(59.2%) demonstrated an objective response, with one(3.7%) achieving a complete clinical response(CR) and fifteen(55.5%) a partial response(PR). After the definitive local
therapy(DLT:
operation or radiation therapy), 12(44.4%) patients had a CR and 12(44.4%)achieved PR, respectively with 88.8% overall response rates.
2) Twelve patients received operation and 15 patients received radiotherapy after the neoadjuvant chemotherapy. Among 12 patients who received operation, seven(58%) patients achieved curative resection with surgery and five(33%) patients a
complete
remission, seven patients(46.7%) a partial remission with radiotherapy.
3) The overall median survival of total 27 patients was 31 months. The median survival of the responders(median: 54 months) to FP chemotherapy was not significantly prolonged compared with nonresponders(median: 23 months).
4) Time to disease progression of the responders to definite local therapy was 19 months.
5) Leukopenia and thrombocytopenia were observed in 48%(grade I-Ⅲ) and 10%(grade I-Ⅱ) respectively. Nausea and vomiting were observed in all patients, but easily controlled. Alopecia, diarrhea, stomatitis and nephrotoxicity were observed
infrequently. There were no treatment related fatalities.
@ES Conclusion:
@EN Neoadjuvant FP chemotherapy in patients with locally advanced head and neck cancer was tolerable, but did not improve the response rate and overall survival compared with previous other reports. The phase Ⅲrandomized controlled prospective
studies
are warranted for the varification of this study.
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