This Article Full Text Full Text (PDF) eLetters: Submit a response to this article Purchase Article View Shopping Cart Alert me when this article is cited Alert me when eLetters are posted Alert me if a correction is posted Citation Map Services E-mail this article link to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Reprints/Permissions Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Argiris, A. Articles by Vokes, E. E. Search for Related Content PubMed PubMed Citation Articles by Argiris, A. Articles by Vokes, E. E.

Intensive Concurrent Chemoradiotherapy for Head and Neck Cancer with 5-Fluorouracil- and Hydroxyurea-Based Regimens: Reversing a Pattern of Failure

^a Division of Hematology-Oncology, Northwestern University, The Feinberg School of Medicine and the Robert H. Lurie Comprehensive Cancer Center, Chicago, Illinois, USA; ^b University of Chicago, Section of Hematology-Oncology, and University of Chicago Cancer Research Center, Chicago, Illinois, USA

Correspondence: Athanassios Argiris, M.D., Northwestern University, The Feinberg School of Medicine, 676 North St. Clair Street, Suite 850, Chicago, Illinois 60611, USA. Telephone: 312-695-6180; Fax: 312-695-6189; e-mail: a-argiris{at}northwestern.edu

Combined modality programs that were developed over the past two decades demonstrated that the nonsurgical therapy of locoregionally advanced head and neck cancer is feasible and produces survival outcomes that are at least comparable with surgery. The systemic therapy of head and neck cancer has gained momentum in recent years. Several randomized studies have shown that the concurrent administration of chemotherapy and radiation therapy is superior to radiation therapy alone. In consecutive clinical studies since 1986, we have developed multiagent chemoradiotherapy regimens based on initial observations with the 5-fluorouracil (5-FU), hydroxyurea, and concomitant radiotherapy combination. Three consecutive multicenter phase II trials reported that the combination of 5-FU and hydroxyurea with either cisplatin or paclitaxel along with twice daily radiation therapy administered every other week is a highly effective regimen with local control rates that approach 90% and 3-year survival rates of approximately 60% in patients with stage IV disease. The vast majority of patients in these studies achieved anatomical organ preservation. A reversal of the historical pattern of failure was evident, with distant sites becoming the predominant site of failure in each trial. The paclitaxel-containing regimen was better tolerated than the cisplatin-containing regimen and was advanced to further clinical testing. The incorporation of induction chemotherapy may improve the results of treatment by targeting systemic micrometastatic disease.

Key Words. Head and neck cancer • Chemotherapy • Radiotherapy • 5-FU • Hydroxyurea

This article has been cited by other articles:

				Q.-T. Le, J. Harris, A. M. Magliocco, C. S. Kong, R. Diaz, B. Shin, H. Cao, A. Trotti, J. T. Erler, C. H. Chung, et al. Validation of Lysyl Oxidase As a Prognostic Marker for Metastasis and Survival in Head and Neck Squamous Cell Carcinoma: Radiation Therapy Oncology Group Trial 90-03 J. Clin. Oncol., September 10, 2009; 27(26): 4281 - 4286. [Abstract] [Full Text] [PDF]

				D. S. Shewach and T. S. Lawrence Antimetabolite Radiosensitizers J. Clin. Oncol., September 10, 2007; 25(26): 4043 - 4050. [Abstract] [Full Text] [PDF]

				J. K. Salama, T. Y. Seiwert, and E. E. Vokes Chemoradiotherapy for Locally Advanced Head and Neck Cancer J. Clin. Oncol., September 10, 2007; 25(26): 4118 - 4126. [Full Text] [PDF]

				E. E.W. Cohen, D. J. Haraf, M. A. List, M. Kocherginsky, B. B. Mittal, F. Rosen, B. Brockstein, R. Williams, M. E. Witt, K. M. Stenson, et al. High Survival and Organ Function Rates After Primary Chemoradiotherapy for Intermediate-Stage Squamous Cell Carcinoma of the Head and Neck Treated in a Multicenter Phase II Trial J. Clin. Oncol., July 20, 2006; 24(21): 3438 - 3444. [Abstract] [Full Text] [PDF]