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Japanese Journal of Clinical Oncology, Vol 29, Issue 10 462-466, Copyright © 1999 by Foundation for Promotion of Cancer Research

CASE REPORTS

Prognosis after salvage chemotherapy for locally unresectable recurrent squamous cell carcinoma of the head and neck

N Kohno, S Kitahara, M Kawaida and T Ohmuma
Department of Otorhinolaryngology, National Defense Medical College, Saitama, Japan.

BACKGROUND: For locally unresectable recurrent squamous cell carcinoma of the head and neck, we investigated two salvage chemotherapy regimens as second-line chemotherapy. In our preliminary study, we observed that both regimens were active. In the present study we analyzed the prognosis of these patients. METHODS:Twenty-six patients with recurrent advanced head and neck cancer, were treated with one of two new regimens as second-line chemotherapy. The PEM regimen consisted of cisplatin 60 mg/m2 on day 1, etoposide 40 mg/m2 on days 1, 2 and 3 and mitomycin-C 7 mg/m2 on day 1. The long CF regimen consisted of cisplatin 8 mg/m2 on days 1-5, 8-12, 15-19 and 22-26 and 5-fluorouracil 300 mg/m2 as a 24 h infusion or oral administration of tegaful-uracil (UFT-E) 400 mg/m2 on days 1-28. Survival curves were calculated using the Kaplan-Meier method and compared by the log rank test. RESULTS: Of 24 patients evaluable for response, three complete responses (CR) and seven partial responses (PR) were achieved, with an overall response rate of 42%. Myelosuppression was the major side effect. One year survival was 100% for CR, 0% for PR and 20% for minor response (MR). All patients who failed to achieve a CR died within 12 months, except one patient with MR. CONCLUSION: Our data suggest that with these salvage regimens survival benefit was demonstrated only in CR patients.
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