Role of chemotherapy in advanced head and neck carcinoma

Abstract

The present study evaluates the response to chemotherapy in 150 histologically proven squamous-cell carcinomas of the head and neck. All cases had stage III and IV (Mo) disease. Two simple regimens either using intravenous methotrexate, or methotrexate, 5-fluorouracil and cyclophosphamide, have been used as out-patients’ programme. Seventy six percent patients obtained some degree of response to chemotherapy, the best responses were seen in carcinoma of the buccal mucosa and the tonsil. The response was significantly better in untreated cases than in recurrent/residual tumours following radiotherapy or surgery. However, complete response at the primary site was observed only in 13 patients three of which recurred within 4 months. One hundred and two patients showed either partial or stable responses. The mean duration of tumour response in latter cases lasted for 3–8 months. Thirty patients were subjected to radical surgery following two courses of preoperative chemotherapy. The author feels that chemotherapy is a useful adjunct to surgery and radiotherapy. Its usefulness in palleation of advanced tumours which are not fit for surgery or radiotherapy is established without doubt. However, it must be stressed that chemotherapy, as a single modality of treatment must not be used alone in cases which are otherwise operable or suitable for radiotherapy.