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5-Fluorouracil Dose Intensification and Granulocyte-Macrophage Colony-Stimulating Factor in Cisplatin-Based Chemotherapy for Relapsed Squamous Cell Carcinoma of the Head and Neck: A Phase II Study

Merlano, Marco M.D.; Benasso, Marco M.D.; Numico, GianMauro M.D.; Danova, Marco M.D.; Santelli, Alida M.D.; Ameli, Franco M.D.; Blengio, Fulvia M.D.; Ricci, Isabella M.D.; Rosso, Matteo M.D.

American Journal of Clinical Oncology: June 1998 - Volume 21 - Issue 3 - p 313-316

A previous phase I study showed that in a 5-day combination of cisplatin (CDDP) 20 mg/m2/day and 5-fluorouracil (5-FU) intravenous bolus, the maximum tolerable dose of 5-FU is 200 mg/m2/day without the use of growth factors and 300 mg/m2/day with recombinant human granulocyte-monocyte colony-stimulating factor (rhGM-CSF) support. In the present phase II study, 26 patients with relapsed and/or metastatic squamous cell carcinoma of the head and neck (SCCHN) were treated with CDDP, 20 mg/m2/day, and 5-FU, 300 mg/m2/day intravenous bolus, for 5 consecutive days every 3 weeks. Granulocyte-macrophage colony-stimulating factor, 5 mg/kg/day subcutaneously, was administered from days 8 to 19. All patients had previously undergone surgery and/or radiation treatment. None had previously received chemotherapy. Mucositis (19% of the patients) and thrombocytopenia (42%) were the most frequent, but generally mild, toxicities. Relevant, GM-CSF-related side effects were detected in 12% of the patients. The median number of cycles delivered was four. Three complete and five partial responses were recorded (31% overall response rate). Further investigation of this regimen is unwarranted because of both its lack of improvement in antitumoral activity and the high costs incurred with the use of growth factors.

From the Department of Medical Oncology I, National Institute for Cancer Research, Genoa (M.M., M.B., G.N., F.B., I.R., M.R.); Department of Medical Oncology, Policlinico S.Matteo, Pavia (M.D.); Department of Otolaryngology, S.Martino Hospital, Genoa (A.S., F.A.); Italy.

Supported in part by the Italian Association for Cancer Research (AIRC).

Address correspondence and reprint requests to Dr. Marco Benasso, Oncologia Medica I, Istituto Nazionale per la Ricerca sul Cancro, Largo R.Benzi 10, 16132 Genova, Italy.

© Lippincott-Raven Publishers.