Neoadjuvant therapy for advanced head and neck cancer with allopurinol-modulated high dose 5-fluorouracil and cisplatin. A phase I-II study

B. Greenberg, Frederick R Ahmann, H. Garewal, C. Koopmann, S. Coulthard, H. Berzes, David S Alberts, D. Shimm, D. Slymen

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Abstract

The combination of cisplatin (100 mg/m2) and 5-fluorouracil (5-FU) by continuous infusion (1 g/m2/day for 5 days) has been reported to produce a high response rate as neoadjuvant therapy for advanced squamous cell head and neck cancer. We sought to improve the response rate by increasing the dose of 5-FU to 1.5 g/m2/day and 2.0 g/m2/day with allopurinol modulation to reduce toxicity. The overall response rate in the 30 patients who received three courses of chemotherapy was 100% with a 50% complete response (CR) rate. A 50% CR rate was observed in patients with T3 (six of 12) and N3 (four of eight) disease. Six patients (four with CR) did not complete subsequent treatment as planned. Seven of 11 (63.6%) chemotherapy complete responders and three of 12 (25%) partial responders (one lost to follow-up) who received all planned treatment are free of disease. The major toxicity encountered was stomatitis (severe in 32%) followed by leukopenia. The maximum tolerated dose of 5-FU in this combination with allopurinol protection was 1.5 g/m2/day. Cisplatin plus high dose 5-FU does not appear to be associated with a higher CR rate than that reported with conventional doses of 5-FU and is more toxic.

Original languageEnglish (US)
Pages (from-to)1860-1865
Number of pages6
JournalCancer
Volume59
Issue number11
DOIs
StatePublished - 1987

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Allopurinol
Neoadjuvant Therapy
Head and Neck Neoplasms
Fluorouracil
Cisplatin
Drug Therapy
Squamous Cell Neoplasms
Stomatitis
Maximum Tolerated Dose
Poisons
Lost to Follow-Up
Leukopenia
Therapeutics

ASJC Scopus subject areas

  • Cancer Research
  • Oncology

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Neoadjuvant therapy for advanced head and neck cancer with allopurinol-modulated high dose 5-fluorouracil and cisplatin. A phase I-II study. / Greenberg, B.; Ahmann, Frederick R; Garewal, H.; Koopmann, C.; Coulthard, S.; Berzes, H.; Alberts, David S; Shimm, D.; Slymen, D.

In: Cancer, Vol. 59, No. 11, 1987, p. 1860-1865.

Research output: Contribution to journalArticle

Greenberg, B. ; Ahmann, Frederick R ; Garewal, H. ; Koopmann, C. ; Coulthard, S. ; Berzes, H. ; Alberts, David S ; Shimm, D. ; Slymen, D. / Neoadjuvant therapy for advanced head and neck cancer with allopurinol-modulated high dose 5-fluorouracil and cisplatin. A phase I-II study. In: Cancer. 1987 ; Vol. 59, No. 11. pp. 1860-1865.
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