Abstract • Chemotherapeutic regimens containing cisplatin are the most effective ones in the treatment of squamous cell carcinoma of the head and neck. Because of the high rate of dose-limiting side effects of cisplatin, carboplatin, a second-generation cisplatin analogue, was tested in a phase II trial with fluorouracil in 55 previously untreated patients with advanced carcinoma of the head and neck. Among the 52 patients who completed the study, there were 17 complete responses (33%), 28 partial responses (54%), five patients with no change (10%), and two with progressive disease (4%). Toxic side effects of all courses summed together included leukopenia in 65% of courses, thrombocytopenia in 45% of courses, nausea or vomiting in 29% of courses, and change in serum creatinine level in 3% of courses. These data were compared with the results of our study with cisplatin and fluorouracil in comparable patients and indicated that carboplatin and fluorouracil is better for induction chemotherapy in the treatment of head and neck cancer than cisplatin and fluorouracil due to similar effectiveness but less toxic effect. (Arch Otolaryngol Head Neck Surg 1989;115:695-698) References 1. Al-Sarraf M: Chemotherapeutic management of head and neck cancer . Cancer Metastasis Rev 1987;6:181-198.Crossref 2. Al-Sarraf M, Metch B, Kish J, et al: Platinum analogs in recurrent and advanced head and neck cancer: A Southwest Oncology Group and Wayne State University study . Cancer Treat Rep 1987;71:723-726. 3. Amrein PC, Weitzman SA: Treatment of squamous-cell carcinoma of the head and neck with cisplatin and 5-fluorouracil . J Clin Oncol 1985;3:1632-1639. 4. Rooney M, Kish J, Jacobs J, et al: Improved complete response rate and survival in advanced head and neck cancer after three-course induction therapy with 120-hour 5-FU infusion and cisplatin . Cancer 1985;55:1123-1128.Crossref 5. Toohill RJ, Anderson T, Byhardt RW, et al: Cisplatin and fluorouracil as neoadjuvant therapy in head and neck cancer . Arch Otolaryngol Head Neck Surg 1987;113:758-761.Crossref 6. Anniko M, Sobin A: Cisplatin: Evaluation of its ototoxic potential . Am J Otolaryngol 1986; 7:276-293.Crossref 7. Forastiere AA, Natale RB, Takasugi BJ, et al: A phase I-II trial of carboplatin and 5-fluorouracil combination in advanced carcinoma of the head and neck . J Clin Oncol 1987;5:190-196. 8. Eisenberger M, Hornedo J, Silva H, et al: Carboplatin (NSC-241-240): An active platinum analog for the treatment of squamous-cell carcinoma of the head and neck . J Clin Oncol 1986;4:1506-1509. 9. Koeller JM, Trump DL, Tutsch KD, et al: Phase I clinical trial and pharmacokinetics of carboplatin (NSC 241240) by single monthly 30-minute infusion . Cancer 1986;57:222-225.Crossref 10. Rauschning W, Schroeder M, Volling P, et al: Phase II trial with carboplatin/5-FU in previously untreated patients with advanced squamous cell carcinoma of the head and neck . Proc ASCO 1988;7:588.
Archives of Otolaryngology - Head & Neck Surgery – American Medical Association
Published: Jun 1, 1989
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