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[Chemo-radiotherapy for head and neck cancer].

Abstract
Many randomized trials have investigated the effect on survival of induction chemotherapy; none however, has demonstrated improved survival. A study of the Department of Veterans Affairs Laryngeal Cancer Study Group demonstrated the feasibility of induction CDDP/5-FU plus surgical salvage as an alternative to initial laryngectomy, but it did not include a radiation-alone treatment arm. Thus, a three-arm trial (R 91-11) was needed to compare the regimen of induction chemotherapy plus surgical salvage treatment with radiation alone and with concurrent chemo-radiation, to determine whether the addition of chemotherapy led to better results than conventional radiation alone. R 91-11 data revealed that concurrent chemo-radiation significantly increased the time to laryngectomy and chemotherapy suppressed distant metastasis, but there was no difference in overall survival. Single-agent docetaxel is known to induce a response in 22-45% of patients with recurrent squamous cell cancer of the head and neck. When used in combination with CDDP, response rates of between 40 and 54% have been reported. Increased expression the epidermal growth factor receptor (EGFR) is reported in head and neck cancer. Anti-EGFR monoclonal antibody is associated with decreased cell proliferation, inhibition of metastasis and angiogenesis, and it has a synergistic effect with chemotherapy or radiotherapy. It is hoped that further advances will lead to greater realization of the therapeutic potential of these compounds as anticancer agents.
AuthorsYasuhisa Hasegawa
JournalGan to kagaku ryoho. Cancer & chemotherapy (Gan To Kagaku Ryoho) Vol. 29 Issue 5 Pg. 677-83 (May 2002) ISSN: 0385-0684 [Print] Japan
PMID12040670 (Publication Type: Journal Article, Review)
Chemical References
  • Antibodies, Monoclonal
  • ErbB Receptors
  • Cisplatin
  • Leucovorin
  • Fluorouracil
Topics
  • Antibodies, Monoclonal
  • Antineoplastic Combined Chemotherapy Protocols (therapeutic use)
  • Cell Division
  • Cisplatin (administration & dosage)
  • ErbB Receptors (immunology, metabolism)
  • Fluorouracil (administration & dosage)
  • Head and Neck Neoplasms (drug therapy, radiotherapy, surgery)
  • Humans
  • Leucovorin (administration & dosage)
  • Neoadjuvant Therapy
  • Randomized Controlled Trials as Topic
  • Survival Rate

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