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J Korean Cancer Assoc > Volume 27(6); 1995 > Article
Journal of the Korean Cancer Association 1995;27(6): 990-1002.
국소 진행성 두경부 상피세포암에 대한 5-Fluorouracil 과 Cisplatin 선행 화학요법의 효과
박지훈, 최환석, 김정희, 김시영, 윤휘중, 조경삼, 홍성언, 류동목, 안회영
Neoadjuvant Chemotherapy with 5-Fluorouracil and Cisplatin for Locally Advanced Head and Neck Cancer
Ji Hoon Park, Hwan Suk Choi, Jeong Hee Kim, Si Young Kim, Hwi Joong Yoon, Kyung Sam Cho, Seong Eon Hong, Dong Mok Ryu, Hoe Young Ahn
Background: The prognosis for patients with locally advanced head and neck cancer remains poor. In recent years, attempts at improving the poor survival rates have frquently focused on the initial use of chemotherapy followed by subsequent standard local therapy with surgery and radiation.
Twenty-seven patients with previously untreated, locally advanced (stage III or IV) head and neck cancer were treated with 2 or 3 cycles of combination chemotherapy consisting of 5-fluorouracil infusion and cisplatin followed by operation or radiotherapy between January,1988 and March,1994.
1) After the neoadjuvant FP chemotherapy, sixteen of 27 patients(59.2%) demonstrated an objective response, with one(3.7%) achieving a complete clinical response(CR) and fifteen(55.5%) a partial response(PR). After the definitive local therapy(DLT:operation or radiation therapy), 12(44.4%) patients had a CR and 12(44.4%) achieved PR, respectively with 88.8% overall response rates. 2) Twelve patients received operation and 15 patients received radiotherapy after the neoadjuvant chemotherapy. Among 12 patients who received operation, seven(58%) patients achieved curative resection with surgery and five(33%) patients a complete remission, seven patients(46.7%) a partial remission with radiotherapy. 3) The overall median survival of total 27 patients was 31 months. The median survival of the responders (median:54 months) to FP chemotherapy was not significantly prolonged compared with nonresponders(median:23 months). 4) Time to disease progression of the responders to definite local therapy was 19 months. 5) Leukopenia and thrombocytopenia were observed in 48%(grade I-III) and l0%(grade I- II) respectively. Nausea and vomiting were observed in all patients, but easily controlled. Alopecia, diarrhea, stomatitis and nephrotoxicity were observed infrequently. There were no treatment related fatalities.
Neoadjuvant FP chemotherapy in patients with locally advanced head and neck cancer was tolerable, but did not improve the response rate and overall survival compared with previous other reports. The phase III randomized controlled prospective studies are warranted for the verification of this study
Key words: Locally advanced head and neck cancer, 5-fluorouracil, Cisplatin, Neoadjuvant chemotherapy
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