Chemotherapy for recurrent or metastatic squamous cell carcinoma of the head and neck

摘要: Recurrent and metastatic squamous cell carcinoma of the head neck (SCCHN) are difficult problems likely to become more challenging as concurrent chemotherapy radiation widely used. Randomized studies reported in 1992 established combination cisplatin infusional 5-fluorouracil (5-FU) reference regimen for chemotherapy-naive, good-performance status patients. Subsequently, a randomized study 194 patients comparing 5-FU paclitaxel found better tolerance, pain relief, improved quality life with newer regimen, but no survival differences (medians 9 months) were detected. Phase II platinum/taxane third drug have response rates greater than 50%, including 15% complete responses. A number non-platinum-containing regimens active pretreated Gefitinib has shown median times comparable those achieved paclitaxel, appears especially promising who recur after cytotoxic chemotherapy. Newer antifolates, agents that target or restore deficient p53, other signal transduction inhibitors under study.