Journal Article

Cisplatin plus Capecitabine as First-Line Chemotherapy for Recurrent or Metastatic Head and Neck Squamous Cell Cancer: Experience Outside of a Trial Setting

Swindell, R., Mitchell, K., Lee, L., Barker, C., Yap, B., Mais, K., Slevin, N.J., McPartlin, A.J., Sykes, A.

2013

Overview

Purpose: Cisplatin/5-fluorouracil (5-FU) is an accepted palliative chemotherapy treatment for head and neck squamous cell carcinoma, improving quality of life but not overall survival. Capecitabine in place of 5-FU removes the morbidity of an infusional regime with potential benefit in patient well-being. This study looks at outcomes for cisplatin plus capecitabine (PX) outside of a trial setting. Methods: Consecutive patients receiving this treatment in a single centre were retrospectively analysed. Cisplatin (mean dose 75 mg/m 2 ) was given on day 1 of a 3-week cycle and capecitabine (mean dose 808 mg/m 2 twice daily) on days 1-14, for up to 6 cycles. Results: Sixty-five patients (median age 58.6 years) received a median of 4 cycles of chemotherapy. The overall response rate was 30.7%, with a median overall survival of 7.3 months. Treatment was well tolerated with a 10.7% grade 3 and a 1.5% grade 4 neutropenia rate, with no other grade 4 toxicities. One patient died of neutropenic sepsis whilst on treatment. Twenty-seven percent of patients stopped treatment early due to chemotherapy-related side effects. Conclusion: PX is well tolerated outside the trial setting with outcomes similar to historical published literature. Ease of administration and benefit to patient convenience make it an attractive alternative to standard palliative treatment.

• Publisher: Karger,S. Karger AG
• Subject: Adult / Aged / Antineoplastic Agents - adverse effects / Antineoplastic Agents - therapeutic use / Biological and medical sciences / Capecitabine / Carcinoma, Squamous Cell - drug therapy / Carcinoma, Squamous Cell - mortality / Carcinoma, Squamous Cell - pathology / Chemotherapy / Cisplatin - adverse effects / Cisplatin - therapeutic use / Clinical outcomes / Clinical Study / Deoxycytidine - adverse effects / Deoxycytidine - analogs & derivatives / Deoxycytidine - therapeutic use / Drug Therapy, Combination / Female / Fluorouracil - adverse effects / Fluorouracil - analogs & derivatives / Fluorouracil - therapeutic use / Head & neck cancer / Head and Neck Neoplasms - drug therapy / Head and Neck Neoplasms - mortality / Head and Neck Neoplasms - pathology / Humans / Kaplan-Meier Estimate / Male / Medical sciences / Metastasis / Middle Aged / Multiple tumors. Solid tumors. Tumors in childhood (general aspects) / Neutropenia - etiology / Otorhinolaryngology (head neck, general aspects and miscellaneous) / Otorhinolaryngology. Stomatology / Recurrence / Retrospective Studies / Tumors