Four-day continuous infusion of cisplatin and 5-fluorouracil in head and neck cancer

Bernal, Amalia Gómez; Cruz, Juan Jesús; Sánchez, Pedro L.; Muñoz, Ángel Sánchez-Anguita; Nieto, Ángel Luis Muñoz; Fonseca, E.; Calle, R; Gómez, Javier

doi:10.1002/1097-0142(19890515)63:10<1927::aid-cncr2820631010>3.0.co;2-1

Cited by 31 publications

(11 citation statements)

References 18 publications

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“…It has been observed that continuous infusion of CDDP decreases nephrotoxicity probably by reducing peak level^.^^,^^ In consideration of the anticancer effect of such a dose schedule, it should be pointed out that Drewinko observed that CDDP cytotoxicity was enhanced by prolonged exposure of malignant cells to the Thus, Bernal et al used a 4-day continuous infusion of cisplatin and 5-fluorouracil in head and neck cancers and observed a response rate of 86% with 40.5% clinically complete responses. 36 These results are similar to those observed in regimens with boluses of cisplatin and continuous infusion of 5-Fluoro~raci1.~'-~~ In our study, in which the regimen of Bernal et al was used, 14% of patients showed a clear subclinical impairment of proprioceptive sensory fibers. We conclude that in chemotherapy regimens in which continuous infusion of CDDP was used without addition of another neurotoxic, the risk for peripheral nerve side effects is low up to a total dose of 300 mg/m2.…”

supporting

confidence: 88%

Low prevalence of cisplatin-induced neuropathy after 4-day continuous infusion in head and neck cancer

Sebille¹,

St-Guily²,

Angelard³

et al. 1990

Cancer

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The toxicity of cisplatin on peripheral nerves was studied using electrophysiologic recordings in 52 patients with head and neck squamous cell carcinoma. Induction chemotherapy (cisplatin: 25 mg/m2/day, days 1-4; 5-fluorouracil: 1 g/mz/day, days 1-4) was administered by continuous infusion every 3 weeks. Electrophysiologic recordings were performed before and after the completion of three courses of chemotherapy (cisplatin total dose: 250-300 mg/m*). The comparison between the recordings showed 14% of the patients had an increase in the latency of the soleus muscle monosynaptic reflex as studied by the Hoffman reflex and 9% showed a decrease in the conduction velocity of the cutaneous sensory fibers of the median nerve. These results indicated a low prevalence of cisplatin-induced neuropathy. The respective roles played by the continuous infusion of the drug and by the potentiation of neurotoxic effects resulting from the association of cisplatin with other neurotoxins is discussed to explain this low toxicity.

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supporting

confidence: 88%

Low prevalence of cisplatin-induced neuropathy after 4-day continuous infusion in head and neck cancer

Sebille¹,

St-Guily²,

Angelard³

et al. 1990

Cancer

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“…Although a variety of chemotherapeutic agents have been employed in the past but the debate to optimize the drugs and the protocol is far from over. Combination of cisplatin with 5-FU has been widely used and investigated in induction chemotherapy settings, with high response rates but comparing with other chemotherapeutic drugs it has severe adverse effects especially mucositis (AlKourainy et al, 1987;Al-Sarraf et al, 1988;Bernal et al, 1989). In our study group all the patients responded to the induction chemotherapy with as high as 15% complete responders.…”

Section: Discussionmentioning

confidence: 99%

Gemcitabine And Cisplatin Followed by Chemo-Radiation for Advanced Nasopharyngeal Carcinoma

Jamshed

Hussain²,

Iqbal³

2014

Asian Pacific Journal of Cancer Prevention

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Concurrent chemo-radiation (CRT) has been established as the standard of care for non-metastatic locoregionally advanced nasopharyngeal carcinoma (NPC) but recently the addition of induction chemotherapy in the already established regimen has presented an attractive multidisciplinary approach. This retrospective study was carried out to evaluate the efficacy of induction chemotherapy (IC) followed by CRT for the management of loco-regionally advanced NPC. Between July 2005 and September 2010, 99 patients were treated with cisplatin based IC followed by CRT. Induction chemotherapy included a 2 drug combination; intravenous gemcitabine 1000 mg/m 2 on day 1 and 8 and cisplatin 75 mg/m 2 on day 1 only. Radiotherapy (RT) was given as a phase treatment to a total dose of 70 Gy in 35 fractions. Concurrent cisplatin (75 mg/m 2 ) was administered to all patients on days 1, 22 and 43. All patients were evaluated for tumor response and adverse effects after IC and 6 weeks after the completion of the treatment protocol. Statistical analysis was performed using SPSS version 17 and Kaplan Meier estimates were applied to project survival. Median follow-up duration was 20 months. The 5-year overall survival (OS), loco regional control (LRC) and relapse free survival (RFS) rates were 71%, 73% and 50%respectively. Acute grade 4 toxicity related to induction chemotherapy and concurrent chemo-radiation was 4% and 2% respectively, with only 3 toxicity-related hospital admissions. We conclude that induction gemcitabine and cisplatin followed by chemo-radiation is a safe and effective regimen in management of nasopharyngeal carcinoma, meriting further investigation in randomized clinical trials.

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“…Postradiation or postoperative adjuvant chemotherapy seldom is tried because compromised vasculature, caused by radiation change or ablative surgery, will reduce drug penetration and the effectiveness of chemotherapy. The majority of clinical trials involve either neoadjuvant or concomitant chemotherapy for advanced SCCHN 3–6, 9–45. In general, the disadvantages of neoadjuvant chemotherapy include delayed primary treatment in nonresponders, refusal of further curative therapy in responders, triggering of accelerated repopulation of surviving clonogens,48 and cross‐resistance to further radiotherapy.…”

Section: Discussionmentioning

confidence: 99%

“…Oncologists have sought to improve local control and survival by combining chemotherapy with standard treatment in patients with advanced solid tumors 7–10. Both neoadjuvant chemotherapy (before surgery or radiotherapy) and concomitant chemotherapy (with radiotherapy) for head and neck tumors have been studied extensively during recent years 3–6, 9–45. However, there still is great controversy regarding the optimal timing, dosage, and contribution of chemotherapy to increase curability.…”

mentioning

confidence: 99%

High rate of clinical complete response to weekly outpatient neoadjuvant chemotherapy in oral carcinoma patients using a new regimen of cisplatin, 5-fluorouracil, and bleomycin alternating with methotrexate and epirubicin

Lin

Jan

Hsu

et al. 1999

Cancer

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BACKGROUND A Phase II trial was initiated to evaluate the response to and toxicity of a new regimen of weekly outpatient neoadjuvant chemotherapy in patients with oral carcinoma. METHODS Patients with previously untreated squamous cell carcinoma of the oral cavity were eligible for this trial. The neoadjuvant chemotherapy was comprised of cisplatin, 25 mg/m2, 5‐fluorouracil, 1000 mg/m2, and bleomycin, 10 mg/m2, mixed in normal saline as a 24‐hour intravenous (i.v.) infusion, alternating with methotrexate, 30 mg/m2, and epirubicin, 30 mg/m2, as an i.v. bolus (PFB/ME) on a weekly schedule for 8–12 weeks. In patients with American Joint Committee on Cancer Stage IV disease who completed neoadjuvant chemotherapy, surgery was preferred to radiotherapy, unless patients refused surgery. RESULTS A total of 40 patients (82.5% with Stage IV disease) with previously untreated oral carcinoma were enrolled. The median size of the primary tumor was 7 cm (range, 3–13 cm). Fifty percent of patients had tumor penetrating through the oral mucosa to the cheek skin and 62.5% had bony destruction. Detectable cervical lymph nodes were noted in 77.5% of patients. After neoadjuvant weekly chemotherapy, 22 patients (55%) showed complete response (CR) and 15 patients (37.5%) showed partial response, for an overall response rate of 92.5%. World Health Organization Grade 3/4 toxicity included mucositis (7.5%), leukopenia (25%), anemia (10%), and thrombocytopenia (2.5%). Eleven of 33 patients with Stage IV disease underwent surgery, and pathologic CR (2 patients) or microscopic residual tumor (4 patients) was noted (54.5%). CONCLUSIONS The results of the current study indicate that a weekly PFB/ME neoadjuvant chemotherapy regimen is highly effective for the treatment of patients with oral carcinoma. In addition, this regimen has low toxicity. The authors believe that implementation of this regimen into a multimodality therapy protocol deserves further study. Cancer 1999;85:1430–8. © 1999 American Cancer Society.

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Four-day continuous infusion of cisplatin and 5-fluorouracil in head and neck cancer

Cited by 31 publications

References 18 publications

Low prevalence of cisplatin-induced neuropathy after 4-day continuous infusion in head and neck cancer

Low prevalence of cisplatin-induced neuropathy after 4-day continuous infusion in head and neck cancer

Gemcitabine And Cisplatin Followed by Chemo-Radiation for Advanced Nasopharyngeal Carcinoma

High rate of clinical complete response to weekly outpatient neoadjuvant chemotherapy in oral carcinoma patients using a new regimen of cisplatin, 5-fluorouracil, and bleomycin alternating with methotrexate and epirubicin

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