Prognosis after salvage chemotherapy for locally unresectable recurrent squamous cell carcinoma of the head and neck.

BACKGROUND For locally unresectable recurrent squamous cell carcinoma of the head and neck, we investigated two salvage chemotherapy regimens as second-line chemotherapy. In our preliminary study, we observed that both regimens were active. In the present study we analyzed the prognosis of these patients. METHODS Twenty-six patients with recurrent advanced head and neck cancer, were treated with one of two new regimens as second-line chemotherapy. The PEM regimen consisted of cisplatin 60 mg/m2 on day 1, etoposide 40 mg/m2 on days 1, 2 and 3 and mitomycin-C 7 mg/m2 on day 1. The long CF regimen consisted of cisplatin 8 mg/m2 on days 1-5, 8-12, 15-19 and 22-26 and 5-fluorouracil 300 mg/m2 as a 24 h infusion or oral administration of tegaful-uracil (UFT-E) 400 mg/m2 on days 1-28. Survival curves were calculated using the Kaplan-Meier method and compared by the log rank test. RESULTS Of 24 patients evaluable for response, three complete responses (CR) and seven partial responses (PR) were achieved, with an overall response rate of 42%. Myelosuppression was the major side effect. One year survival was 100% for CR, 0% for PR and 20% for minor response (MR). All patients who failed to achieve a CR died within 12 months, except one patient with MR. CONCLUSION Our data suggest that with these salvage regimens survival benefit was demonstrated only in CR patients.