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Persons who have squamous cell cancer of the head or neck often receive chemotherapy with cisplatin and fluorouracil, followed by radiation therapy. While this is an effective therapy for many persons, others experience a recurrence (return) of the cancer after treatment. Researchers in Boston recently found that a new chemotherapy combination—docetaxel, cisplatin, fluorouracil, and leucovorin—produces a high rate of complete responses and may hold promise as an alternative treatment option.

The term

head and neck cancer is used to refer to a number of cancers that may occur in the head and/or neck. These may include cancers of the tongue, mouth, salivary glands, pharynx, larynx, sinus, and other sites located in the head and neck area. Treatment options may include surgery, radiation therapy, and/or chemotherapy, depending on the specific type, location, and stage (extent of disease at diagnosis) of the cancer. Biologic therapies, such as Neupogen, may also be used to help speed up the recovery of blood cell counts, which may become low as a side effect of chemotherapy. For a common type of head and neck cancer called

squamous cell, 1 of the more frequently used chemotherapy regimens is cisplatin plus fluorouracil. However, researchers at the Dana Farber Cancer Institute in Boston recently treated persons with this type of cancer with the docetaxel, cisplatin, fluorouracil, and leucovorin combination.

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Thirty persons with stage III or IV squamous cell cancer of the head or neck who had not had previous treatment received an average of 3 cycles of a 4-day regimen of docetaxel, cisplatin, fluorouracil, and leucovorin. Neupogen was administered with each cycle of chemotherapy to facilitate white blood cell recovery. The results showed that 63% of patients achieved a complete response, and 30% had a partial response to this therapy. After 1 year, 60% of persons were alive and free of disease. Major side effects with the treatment included mucositis (an inflammation of the mucous tissues that often manifests as sores in the mouth) and nausea. The administration of 14% of all the chemotherapy cycles given required hospitalization.

These researchers concluded that the docetaxel, cisplatin, fluorouracil, and leucovorin combination shows promise for the treatment of squamous cell cancer of the head or neck and should now be compared directly with other commonly used treatments. Persons with this type of cancer may wish to talk with their doctor about the risks and benefits of this new chemotherapy combination, or of participating in a clinical trial in which other new treatments are being studied. (

Journal of Clinical Oncology, Vol 17, No 11, pp 3503-3511, 1999)

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