Outpatient chemotherapy for recurrent and/or advanced squamous cell carcinoma of the head and neck

Background. The efficacy of the treatment of cancer has been traditionally judged by outcome measures such as disease-free survival, overall survival, and tumor response rate. Our goal of salvage and/or adjuvant chemotherapy is to improve not only the survival period but also the quality of life (QOL). The conventional regimens containing cisplatin (CDDP) require hospitalization of patients, which has been responsible for disappointingly low QOL. Thus, we developed a new outpatient regimen that has same magnitude of activity and less toxicity compared with conventional CDDP- containing regimens. Methods. Sixteen patients with recurrent or advanced head and neck cancer were treated by the outpatient setting Long-CF regimen. The Long-CF regimen consisted of cisplatin (CDDP) (CDDP, 5 mg/m2/2 h infusion on days 1-5, 8-12, 15-19, 22-26) and 5-fluorouracil (5-FU) [oral administration of tegaful-uracil (UFT-E), 400 mg/body on days 1-28]. Results. Among 16 patients entered in this trial, 1 patient was disqualified from analysis for reasons of protocol violation. Of 15 patients evaluable for response, 2 complete responses (13%) and 4 partial responses (27%) were achieved, with an overall response rate of 40%. Myelosuppression was the major side effect. Leukopenia and anemia (13% greater than WHO grade III) were dose-limiting toxicities. Other adverse reactions including mucositis were all mild and transient. Conclusion. As this regimen is given in an outpatient setting, we concluded that this regimen produced a beneficial effect in patients with recurrent and/or advanced head and neck cancer. Moreover, the toxicity of this regimen was limited; thus, attempts to increase the complete response rate by dose escalation or intensive scheduling appear warranted.