Vol.100 No.4 contentsPRACTICA OTO-RHINO-LARYNGOLOGICA
Vol. 100 No. 4 April 2007
Chemotherapy for Pulmonary Metastases of Squamous
Cell Carcinoma of the Head and Neck
Jun Watanabe, Hidenori Boku, Misako Hashimoto and Osamu Semba
(Osaka Kouseinenkin Hospital)
Masamitsu Nagahara
(Nagahara Otolaryngological Clinic)
We report six cases of pulmonary metastases of squamous cell carcinoma of the head and neck (SCCHN) treated with modified TPF chemotherapy (docetaxel combined with nedaplatin and 5-FU).
All patients received 4 courses of TPF chemotherapy every 3 weeks, docetaxel 60 mg/m2 on day 1; nedaplatin 75 mg/m2 on day 1 and 5-FU 1000 mg/body by continuous infusion on days 1 to 4.
Chemotherapy-associated grade 3 fatigue, fever and diarrhea occurred in one patient each. Grade 3 or 4 leucopenia was observed in 2 patients, and thrombocytopenia was in 3 patients.
Clinically there were 3 complete and 3 partial responders. Partial responders died of pulmonary metastases 7, 8 and 12 months after the diagnosis of metastasis. In one of the complete responders, pulmonary metastases recurred 8 months after the diagnosis of pulmonary metastasis, and at 20 months he died of acute myocardial infarction. In another complete responder it recurred 22 months after diagnosis and the remaining patient is free of pulmonary metastasis at 25 months.
Overall, TPF chemotherapy is associated with a high rate of clinical response (100％) and complete response (50％) for pulmonary metastases of SCCHN. However, partial responders died by 12 months after diagnosis, and partial response is suspected not to be related with prognosis.
TPF chemotherapy will improve the prognosis and quality of life.
Key words : head and neck cancer, pulmonary metastasis, docetaxel nedaplatin fluorouracil