Metastatic Squamous Cell Carcinoma Of Head Research Articles

Estimation of treatment effects and model diagnostics with two-way time-varying treatment switching: an application to a head and neck study.

Treatment switching frequently occurs in clinical trials due to ethical reasons. Intent-to-treat analysis without adjusting for switching yields biased and inefficient estimates of the treatment effects. In this paper, we propose a class of semiparametric semi-competing risks transition survival models to accommodate two-way time-varying switching. Theoretical properties of the proposed method are examined. An efficient expectation-maximization algorithm is derived to obtain maximum likelihood estimates and model diagnostic tools. Existing software is used to implement the algorithm. Simulation studies are conducted to demonstrate the validity of the model. The proposed method is further applied to data from a clinical trial with patients having recurrent or metastatic squamous-cell carcinoma of head and neck.

Continuous infusion of 5-FU with split-dose cisplatin: An effective treatment for advanced squamous-cell carcinoma of the head and neck

The purpose of this study was to determine if a combination chemotherapy, using continuous intravenous infusion of fluorouracil (5-FU) in combination with split-dose cisplatin, in patients with recurrent or metastatic head and neck squamous-cell could improve previously reported clinical outcomes. Forty-two patients with recurrent or metastatic head and neck squamous-cell cancer were treated by cisplatin (25 mg/m(2)/day on days 1-3) and 5-FU (750 mg/m(2)/day for 120 hours; continuous intravenous infusion on days 1 through 5) with a cycle that repeated every 3 weeks. Of the 42 patients, 8 (19.1%) showed complete response and 12 (28.5%) demonstrated a partial response, giving an overall response rate of 47.6%. Response rates were significantly different for patients undergoing initial treatment vs. re-treatment:73.6% (14/19) vs. 25.9% (6/23), respectively (χ(2)=9.45, P < 0.05). Median time to progression was 7.2 months and median overall survival was 13.7 months. The 1 year survival was 57.1%. Toxicity mainly included myelo-suppression, mucositis, nausea and vomiting. Chemotherapy with 5-FU by continuous intravenous infusion in combination with split-dose cisplatin is effective with a tolerable toxicity profile in patients with recurrent, or metastatic squamous-cell carcinoma of head and neck. The overall response was significantly higher in patients undergoing initial treatment in comparison with patients undergoing re-treatment after relapse.

Combined use of cetuximab and chemotherapy in recurrent or metastatic squamous cell carcinoma of head and neck

Recurrent or metastatic squamous cell carcinoma of the head and neck(SCCHN) has a poor prognosis. Cetuximab is a monoclonal antibody that inhibits epidermal growth factor receptor (EGFR) and improves the effect of several chemotherapeutical agents including cisplatin. Several clinical trials have shown that cetuximab combined with chemotherapy was effective and well tolerated for the treatment of recurrent or metastatic SCCHN. The strengths of such treatment are its high efficacy and low toxicity. Key words: Antibodies, monoclonal; Head and neck neoplasms; Carcinoma, squamous cell; Drug therapy