ISSN:
1569-8041
Schlagwort(e):
cisplatin
;
disseminated disease
;
docetaxel
;
head and neck cancer
;
recurrent disease
;
squamous-cell carcinoma
Quelle:
Springer Online Journal Archives 1860-2000
Thema:
Medizin
Notizen:
Abstract Background:Results with docetaxel as single drug in squamous-cellhead and neck cancer have been encouraging. The purpose of the present phaseII study is to evaluate the antitumour efficacy and toxicity of thecombination of docetaxel and cisplatin in patients with recurrent ordisseminated squamous-cell carcinoma of the head and neck (SCCHN) for whom nocurative therapy is available. Patients and methods:Eligibility criteria included: writteninformed consent; WHO performance status ≤2; age 18–70 years;adequate bone marrow, liver, and renal function; measurable or evaluabledisease; no previous systemic chemotherapy (prior radiotherapy and/or surgerywere allowed); no other previous or concurrent malignancy; no peripheralneuropathy. Treatment consisted of docetaxel 75 mg/m2 in a one-hourinfusion after pre-treatment with prednisolone, followed by cisplatin 75mg/m2 in a half-hour infusion preceded and followed by hydration.Treatment was repeated every three weeks for a maximum of eight cycles. Results:Twenty-five patients (median age 52 years, range33–66) entered the trial, all were evaluable for survival, twenty-fourfor response and toxicity. Twenty-four patients had undergone priorradiotherapy and seventeen had also had surgery. Nineteen had local-regionalrecurrence only, three had local-regional disease and distant metastases, andthree had distant metastases only. Patients received a median of 5 treatmentcycles (range 2–8). Overall response rate was 33% (8 of 24) ofpatients; complete response rate was 8% (2 of 24) of patients, lasting2.2 and 17.1 months, respectively; partial response rate was 25% (6 of24) of patients, lasting for a median of 4.9 months (range 1.7–11.6months). Median survival was 11 months. Toxicity was relatively welltolerated. However, one patient died of probable toxicity (neutropenia andinfection) and three patients discontinued treatment because of toxicity(massive oedema, myocardial infarction, persistent thrombocytopenia). The mostfrequent moderate-to-severe toxicity (75% of patients) was grade3–4 neutropenia, transient in all but one patient. Grade 3 neuropathyoccurred in one patient, none had grade 4. Grade 3 oral mucositis occurred inthree patients, none had grade 4. Grade 2–3 hypomagnesaemia occurred in10 patients requiring magnesium infusion. Conclusions:Docetaxel and cisplatin is an active combination inpatients with recurrent or disseminated SCCHN. Remissions are however fairlyshort. Toxicity is significant, but generally manageable.
Materialart:
Digitale Medien
URL:
http://dx.doi.org/10.1023/A:1008355315205
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