Fluorouracil modulation in head and neck cancer.

Abstract

The majority of patients with head and neck cancer present with locoregionally advanced disease (1–3). For most of these patients, standard therapy consists of surgery followed by radiotherapy, unless the patient has unresectable disease due to the specific anatomic location (e.g. nasopharynx) or widespread involvement of neighboring structures, or is medically inoperable. In these cases, standard therapy consists of radiotherapy alone. However, less than 30% of patients are cured and locoregional disease persistence/ recurrence is the most common pattern of failure. Distant metastases, second malignancies, and medical problems related to smoking and alcohol consumption are significant additional causes of treatment failure and death (4,5). Chemotherapy has traditionally been investigated in patients with recurrent or metastatic disease (1–3). In that setting, response rates of 30% with a median response duration of 3 months are usually achieved. Commonly used regimens include single agent methotrexate or cisplatin, and the combination of cisplatin and a 4 to 5 day continuous infusion of fluorouracil. The latter combination, in particular, has been frequently investigated with response rates ranging from 20% to 74% (6).KeywordsClin OncolNeck CancerInduction ChemotherapyAdvanced HeadLocoregional TherapyThese keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.