Multi-Drug Combination Chemotherapy Including Cisplatin And 5-Fu For Advanced Head And Neck Cancer

Curative treatment for head and neck carcinomas consists of surgery and/or radiotherapy. However, standard treatment is less successful in cases of advanced head and neck carcinomas. The efficacy of chemotherapy has been discussed in the treatment of head and neck cancer. Neo-adjuvant chemotherapy including cisplatin (CDDP) and 5-FU (CF chemotherapy) has been applied for advanced head and neck squamous cell carcinomas. The previous studies have demonstrated that this chemotherapy is efficacious for patients with a high complete response (CR) rate, resulting in organ preservation and the improvement of prognosis. Furthermore, the development of intensive chemotherapy regimen showing higher CR rate is necessary.To improve CR rate of CF chemotherapy, we had designed and applied modified CF chemotherapy (5-FU followed by CDDP). In clinical studies on modified CF chemotherapy, the clinical CR rate was 20% and the 5 year-survival rate of the CR cases with advanced pharyngeal cancer was 68%. Recently, 4-drug combined chemotherapy has been applied. The regimen of the chemotherapy was as follows : 5-FU (800mg/m(2) continuous i.v. infusion) administration from day 1 to 5, MTX (30mg/m(2) i.v.) administration on day 1, LV (20mg/m(2) i.v.) administration from day 1 to 5, CDDP (60mg/m(2) d.i.v.) administration on day 4. We present the clinical result of this chemotherapy.