Journal of the Chinese Medical Association
Volume 71, Issue 7 , Pages 336-341, July 2008

Methotrexate and Leucovorin Double-modulated 5-Fluorouracil Combined with Cisplatin (MPFL) in Metastatic/Recurrent Head and Neck Cancer

  • Peter Mu-Hsin Chang

      Affiliations

    • Division of Medical Oncology, Department of Medicine, Taipei Veterans General Hospital, Taipei, Taiwan, R.O.C.
    • National Yang-Ming University School of Medicine, Taipei, Taiwan, R.O.C.
    • ,
  • Hao-Wei Teng

      Affiliations

    • Division of Medical Oncology, Department of Medicine, Taipei Veterans General Hospital, Taipei, Taiwan, R.O.C.
    • National Yang-Ming University School of Medicine, Taipei, Taiwan, R.O.C.
    • ,
  • Po-Min Chen

      Affiliations

    • Division of Medical Oncology, Department of Medicine, Taipei Veterans General Hospital, Taipei, Taiwan, R.O.C.
    • National Yang-Ming University School of Medicine, Taipei, Taiwan, R.O.C.
    • ,
  • Shyue-Yih Chang

      Affiliations

    • Department of Otolaryngology, Taipei Veterans General Hospital, Taipei, Taiwan, R.O.C.
    • ,
  • Pen-Yuan Chu

      Affiliations

    • Department of Otolaryngology, Taipei Veterans General Hospital, Taipei, Taiwan, R.O.C.
    • ,
  • Tung-Lung Tsai

      Affiliations

    • Department of Otolaryngology, Taipei Veterans General Hospital, Taipei, Taiwan, R.O.C.
    • ,
  • Shyh-Kuan Tai

      Affiliations

    • Department of Otolaryngology, Taipei Veterans General Hospital, Taipei, Taiwan, R.O.C.
    • ,
  • Yi-Fen Wang

      Affiliations

    • Department of Otolaryngology, Taipei Veterans General Hospital, Taipei, Taiwan, R.O.C.
    • ,
  • Jui-Lin Huang

      Affiliations

    • Department of Otolaryngology, Taipei Veterans General Hospital, Taipei, Taiwan, R.O.C.
    • ,
  • Muh-Hwa Yang

      Affiliations

    • Division of Medical Oncology, Department of Medicine, Taipei Veterans General Hospital, Taipei, Taiwan, R.O.C.
    • National Yang-Ming University School of Medicine, Taipei, Taiwan, R.O.C.
    • Corresponding Author InformationCorrespondence to: Dr Muh-Hwa Yang, Division of Medical Oncology, Department of Medicine, Taipei Veterans General Hospital, 201, Section 2, Shih-Pai Road, Taipei 112, Taiwan, R.O.C

Received 17 December 2007; accepted 23 May 2008.

Background

To determine the efficacy and safety profile of the combination of cisplatin and 5-fluorouracil modulatedboth by methotrexate and leucovorin in metastatic/recurrent squamous cell carcinoma of the head and neck.

Methods

Twenty-eight patients were treated with cisplatin 40 mg/m2/day continuous infusion for 24 hours on day 1;high-dose 5-fluorouracil 2,000 mg/m2/day and leucovorin 100 mg/m2/day continuous infusion for 48 hours on days 1and 2; methotrexate 40 mg/m2/day as a bolus infusion 4 hours before 5-fluorouracil and leucovorin on day 1. The treat-ment was repeated every 2 weeks in a cycle.

Results

The overall response rate was 25%, and 14% of the patients achieved stable disease status. Subgroup analy-sis demonstrated significantly improved overall survival in the disease-control group (12.0 months vs. 5.3 months,p < 0.001). Only 3 (10.7%) patients developed grade 3–4 neutropenia, and none developed grade 3–4 non-hematologictoxicity.

Conclusion

This multiagent-containing regimen has an excellent safety profile and improved survival in disease-controlgroup of patients with metastatic/recurrent squamous cell carcinoma of the head and neck.

Key Words:  cisplatin , fluorouracil , head and neck cancer , methotrexate , mucositis

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PII: S1726-4901(08)70135-7

doi:10.1016/S1726-4901(08)70135-7

Journal of the Chinese Medical Association
Volume 71, Issue 7 , Pages 336-341, July 2008

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