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British Journal of Radiology 74 (2001),368-374 © 2001 The British Institute of Radiology

Full paper

Radiotherapy combined with simultaneous chemotherapy with mitomycin-C and 5-fluorouracil for inoperable head and neck cancer

O Pradier, MD 1 K Eberlein, MD 1 E Weiss, MD 1 M C Jackel, MD 2 and C F Hess, MD, PhD 1

1 Radiotherapy 2 Otorhinolaryngology, University of Göttingen, Robert Koch Strasse 40, D 37075 Göttingen, Germany

in final form 12 October 2000

The feasibility and effectiveness of a combined chemoradiotherapy treatment modality for locally advanced head and neck cancer was tested in a phase II trial. From March 1995 to June 1998, 35 patients with advanced squamous cell carcinoma of the head and neck were treated with a continuous intravenous infusion of 5-fluorouracil (600 mg m-2 24 h-1 for Days 1 to 5 (120 h)) and mitomycin-C (10 mg m-2 intravenously) on Day 5 during the first week of radiotherapy and on Day 36. 31 patients had stage IV disease; 4 patients had stage III; and 1 patient had stage II. Patient ages ranged from 42–69 years (median 56.7 years). The tumours involved were as follows: oral cavity (n=11); oropharynx (n=14); hypopharynx/larynx (n=10). Radiotherapy was delivered to a total dose of 70 Gy with conventional fractionation (2 Gy per fraction, five times a week). Chemotherapy was well tolerated and all patients received the intended dose. Mild nausea occurred in five patients. After a mean follow-up of 21 months (range 10–44 months), 8 (23%) patients remain alive. A complete response was seen in 28 (80%) patients. When a recurrence appeared, it was within the first year after treatment. 1- and 2-year overall survival rates were 46% and 23%, respectively. Grade 3 mucositis occurred in 17% of patients. Grade 1–2 thrombopaenia occurred in 3 (9%) patients, grade >2 leukopaenia in 4 (11%) patients, and grade =>2 anaemia in 3 (9%) patients. We observed a treatment interruption of maximum 1 week for six patients owing to mucositis. Febrile neutropaenia or aplasia were not observed. The concomitant use of 5-fluorouracil, mitomycin-C and radiotherapy in locally advanced head and neck carcinoma is well tolerated in this group of patients. This protocol showed good locoregional response with a very low toxicity profile.




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M. Rastogi, M. Srivastava, K. S. Chufal, M. C. Pant, K. Srivastava, and M. B. Bhatt
Mitomycin and Fluorouracil in Combination with Concomitant Radiotherapy: A Potentially Curable Approach for Locally Advanced Head and Neck Squamous Cell Carcinoma
Jpn. J. Clin. Oncol., October 1, 2005; 35(10): 572 - 579.
[Abstract] [Full Text] [PDF]


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