Chemotherapy of Head and Neck Cancer

Abstract

Single agent chemotherapy employing either hydroxyurea, cyclophosphamide, bleomycin, o r methotrexate has been reported to produce objective remissions in 30-40% of patients with advanced epidermoid carcinoma of the head and neck region. Responses are usually incomplete with remission durations of a few months. Methotrexate, the most extensively studied agent, appears to be most effective when used in a n intermittent (every 4-7 day) dosage schedule o r when used in high dosage followed by leucovorin "rescue." I n some reports, the intra-arterial administration of these drugs achieved better response rates, but the value of this approach is diminished by the high frequency of lesions that extend beyond the infused arterial supply and the high complication rate of catheterization procedures. Initial studies with dichlo-romethotrexate, a n equipotent analog of methotrexate which is hydroxylated to a n inactive form by the liver, suggest that intra-arterial use of this unique compound may be of value. Several studies indicate that the use of drugs in combination with radiotherapy may achieve greater tumor regression and longer response durations than radiotherapy alone; however, more controlled studies will be needed to establish this. T h e availability of effective agents with diverse mechanisms of action strongly suggests that major gains in chemotherapy of these tumors will be made in the next decade using combinations of drugs. PIDERMOID CARCINOMA OF T H E HEAD AND E neck region continues to be a therapeutic challenge to the surgeon, the radiotherapist , and the medical oncologist. Despite the fact that most of these lesions tend to remain local, and spread to a variable degree to regional nodes, cure rates for the advanced lesions, especially those with lymph node involvement , remain poor. Five-year survival rates's for these Stage 111 and IV lesions range from 3-34%, depending on the anatomic site, the histologic grade, and the presence or absence of nodal disease. Therefore, ideally each lesion should be carefully stagecIlSJ6 accord

Synthesis and Antitumor Activity of a Series of [2-Substituted-4,5-bis(aminomethyl)-1,3-Dioxolane]platinum(II) Complexes

“…NH2),1.40-1.80 (m,10 H, 5 CH2), 2.78-2.93 (m, 4 H, 2 CH2),3.70-3.80 (m, 2 H, 2 CH); 13C NMR (CDClg) 23.71,25.00, 36.74, 44.20, 79.55,109.06; EI-MS m/z 200 (M+). Anal.…”