Long term results of a phase II trial of Induction Chemotherapy with Uracil-Ftegafur (UFT), Vinorelbine and Cisplatin (UFTVP) followed by Radiotherapy concomitant with UFT and Carboplatin (RT/UFTJ) in Non-Resectable Locally Advanced (Stage IV-B) Squamous Cell Head and Neck Carcinoma and Peripheral Blood Stem Cell Support (PBSCS) with Febrile Neutropenia

Purpose.

To evaluate the response of advanced squamous cell head and neck carcinoma to a combination of induction chemotherapy and radiotherapy.

Methods.

We present long-term results of a phase II trial of Induction Chemotherapy with UFT 200 mg/m ² p.o. days 1 to 21, Vinorelbine 25 mg/m ² i.v. days 1 and 8 and Cisplatin 100 mg/m ² i.v. day 1 (UFTVP) each 21 days for 4 courses, followed by Radiotherapy concomitant with UFT 100 mg/m ² p.o. daily and Carboplatin AUC = 0.5 i.v. weekly (RT/UFTJ) in patients (pts) with Non-Resectable Locally Advanced (Stage IV-B) Squamous Cell Head and Neck Carcinoma (IV-B-SCHNC). Primary endpoint was Complete Response to induction UFTVP and secondary endpoints were Disease Free Status Rate after locoregional treatment and long-term Overall Survival. Between 1994 and 1997, 32 pts were included.

Results.

Complete Response to Induction UFTVP was 59% (95% CI: 48%-70%). Main toxicity of UFTVP was G 3,4 neutropenia (94% of pts; 25% developed febrile neutropenia and 1 of this pts dead). After Induction Chemotherapy with UFTVP, 30 pts received radiotherapy and 25 of them received cocomitant Carboplatin and UFT (RT/UFTJ): main toxicity was mucositis (G3-4: 72%) and one patient died during RT/UFTJ because pneumonia. Twenty-five pts (78%) were alive and disease free at the end of the whole treatment. Actuarial 5 year Overall survival is 32%.

Conclusion.

Although toxicity is important, this approach has interesting activity and deserves further investigation.