CIS-DICHLORODIAMMINEPLATINUM (II) IN TREATMENT OF EPIDERMOID CARCINOMA OF HEAD AND NECK

Abstract

Patients (26) with advanced epidermoid carcinoma of the head and neck were treated with cis-dichlorodiammineplatinum(II) (DDP) in high doses, utilizing the technique of concurrent mannitol induced diuresis. All 26 patients received prior radical radiotherapy to local disease, 14 had major ablative surgical procedures and all but 5 were previously treated with chemotherapy. Responses were as follows (duration in months): 2 complete (2+, 6+), 6 partial (1, 2, 3, 4, 5+, 8+), 10 minor (all but 1 < 1.5) and 8 no change or progression. Responses were seen in primary tumors, neck nodes and pulmonary metastases. Nausea and vomiting were seen consistently in all patients but were never dose limiting. Myelosuppression was mild, with only 3 patients developing platelet counts < 50,000/mm3 and no patient with a wbc [white blood cell] count < 2000/mm3. Transient elevations of serum creatinine were common but no patient developed peak levels > 2 mg/dl. Transient tinnitus was also common although only 4 patients developed clinically significant hearing loss during the trial and DDP could be definitely implicated in only 1 instance. DDP in this dose and schedule is effective and safe therapy in a heavily pretreated group of patients with advanced head and neck cancer and is now being used in combination with other agents in the initial treatment of these patients.