ISSN:
1569-8041
Keywords:
carboplatin
;
chemotherapy
;
head and neck cancer
;
nasopharyngeal cancer
;
paclitaxel
Source:
Springer Online Journal Archives 1860-2000
Topics:
Medicine
Notes:
Abstract Background: Paclitaxel has been demonstrated to have significant activityin recurrent or metastatic head and neck cancer (HNC). In addition, thecombination of paclitaxel and cisplatin is active in untreated patients withinoperable HNC. Substitution of carboplatin for cisplatin allows the treatmentto be delivered on an outpatient basis. Purpose of the study: To evaluate the activity and toxicity of thecombination of paclitaxel by three-hour infusion and carboplatin as first-linechemotherapy in patients with recurrent or metastatic HNC. Patients and methods: From March 1994 until August 1996, 49 patients withrecurrent or metastatic HNC were treated with paclitaxel (200mg/m2, by three-hour infusion) followed by carboplatin at anAUC of 7 mg·min/ml, every four weeks. G-CSF was administeredprophylactically on days 2 to 12 of each cycle. There were 41 men and 8 womenwith a median age of 57 years (range 23–73). The majority of thepatients were symptomatic and they had recurrent disease locoregionally.Fourteen patients had nasopharyngeal cancer (NPC) and 35 had squamous cellcancers of other areas of the head and neck region (non-NPC). Results: At the completion of treatment, two patients with NPC demonstratedcomplete and six partial responses for an overall response rate of 57%(95% CI 29%–82%). Among patients with non-NPC, theresponse rate was 23% (95% CI 9%–37%). Aftera median follow up period of 15 months, the median time to progression was 4.3months in the non-NPC group and 16.5 months in the NPC group. At the time ofthe analysis, median survival had not been reached in NPC while it was 7.3months in non-NPC patients. Grade 3–4 toxicities included anemia(2%) and leukopenia, thrombocytopenia, stomatitis, nausea/vomiting anddiarrhea (4% each). Conclusions: The combination of paclitaxel and carboplatin appears to bewell tolerated but only moderately active in patients with advanced non-NPCof the head and neck region. However, its activity appears promising in NPCand deserves further investigation.
Type of Medium:
Electronic Resource
URL:
http://dx.doi.org/10.1023/A:1008279503428
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