Adult ; Aged ; Antineoplastic Combined Chemotherapy Protocols/therapeutic use* ; Carcinoma, Squamous Cell/mortality ; Carcinoma, Squamous Cell/pathology ; Carcinoma, Squamous Cell/therapy* ; Cisplatin/administration & dosage ; Cisplatin/adverse effects* ; Disease-Free Survival ; Dose-Response Relationship, Drug ; Drug Administration Schedule ; Female ; Fluorouracil/administration & dosage* ; Fluorouracil/adverse effects ; Head and Neck Neoplasms/mortality ; Head and Neck Neoplasms/pathology ; Head and Neck Neoplasms/therapy* ; Humans ; Lymphatic Metastasis ; Male ; Middle Aged ; Mucositis/etiology ; Neoplasm Recurrence, Local ; Radiotherapy, Adjuvant ; Radiotherapy, Conformal/adverse effects ; Survival Rate
Keywords
head-and-neck cancer ; chemotherapy ; radiotherapy ; 5-fluorouracil ; cisplatin
Abstract
BACKGROUND: In locally advanced head and neck cancer, concurrent chemoradiotherapy (CRT) with combined 5-fluorouracil (5-FU) and cisplatin has increased acute toxicities as well as survival. Once-weekly chemotherapeutic administration schedule may reduce severe toxicities. Thus, we investigated CRT using weekly administration of 5-FU-cisplatin in locally advanced head and neck cancer.
METHODS: In a single-arm, phase II study, CRT included radiation (70.0 Gy/35 fr) and weekly 5-FU (750 mg/m2) and cisplatin (20 mg/m2).
RESULTS: Thirty-two patients completed planned radiation. Thirteen (41%) achieved complete response, and 16 (50%) partial response. Twelve patients (38%) experienced acute grade 3 toxicities. Grade 3 mucositis, which was the most common toxicity, developed in 5 (16%) patients. The survival rates at 1 and 2 years were 81% and 76%, respectively. The progression-free survival rates at 1 and 2 years were 69% and 66%, respectively.
CONCLUSIONS: We demonstrated weekly 5-FU-cisplatin with conventional radiotherapy was efficacious and feasible with high compliance rate in locally advanced head and neck cancer.