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Analysis of efficacy and toxicity of chemotherapy with cisplatin, 5-fluorouracil, methotrexate and leucovorin (PFML) and radiotherapy in the treatment of locally advanced squamous cell carcinoma of the head and neck

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Abstract

Purpose

The aim of this study was to evaluate the efficacy and toxicity of concurrent chemoradiotherapy using cisplatin (CDDP), 5-fluorouracil (5-FU), methotrexate (MTX) and leucovorin (LV) (PFML) in patients with locally advanced squamous cell carcinoma of the head and neck (SCCHN).

Methods

Seventy-seven patients with previously untreated stages III–IV SCCHN were included in this trial. Patients received two cycles of chemotherapy repeated every 4 weeks. The chemotherapy regimen consisted CDDP (60 mg/m2, day 4), 5-FU (600 mg/m2 given over 24 h for 5 days, days 1–5), MTX (30 mg/m2, day 1) and LV (20 mg/m2, days 1–5). Radiation was targeted to begin on the starting day of chemotherapy, day 1. The total radiation dose to the primary site and neck lymph nodes was 70.0 Gy. When grade ≥3 toxicities were observed frequently, radiotherapy and/or chemotherapy were delayed or reduced.

Results

The main toxicities were mucositis (grade ≥3, 39%), leukocytopenia (grade ≥3, 34%) and neutropenia (grade ≥3, 30%). The overall clinical response rate and the pathological complete response (CR) were 94% (72/77) and 71% (55/77). The primary site CR and neck lymph node CR were 79% (61/77) and 85% (44/52), and 3-year survival rate was 73%.

Conclusions

This concurrent chemoradiotherapy with PFML was safe and well tolerated. The high CR rate justifies further evaluation of this chemoradiotherapy modality in locally advanced SCCHN patients.

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Authors and Affiliations

  1. Department of Otolaryngology, Yokohama City Minato Red Cross Hospital, 3-12-1 Shin-Yamashita, Naka-ku, Yokohama, 231-8682, Japan

    Hideaki Katori

  2. Department of Otolaryngology, Yokohama City University Medical Center, 4-57 Urafune-chou, Minami-ku, Yokohama, 232-0024, Japan

    Hideaki Katori

  3. Department of Otolaryngology, Yokohama City University School of Medicine, 3-9 Fukuura, Kanazawa-ku, Yokohama, 236-0004, Japan

    Mamoru Tsukuda & Takahide Taguchi

Authors
  1. Hideaki Katori
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  2. Mamoru Tsukuda
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  3. Takahide Taguchi
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Correspondence to Hideaki Katori.

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Katori, H., Tsukuda, M. & Taguchi, T. Analysis of efficacy and toxicity of chemotherapy with cisplatin, 5-fluorouracil, methotrexate and leucovorin (PFML) and radiotherapy in the treatment of locally advanced squamous cell carcinoma of the head and neck. Cancer Chemother Pharmacol 59, 789–794 (2007). https://doi.org/10.1007/s00280-006-0335-1

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  • DOI: https://doi.org/10.1007/s00280-006-0335-1

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