s0007 - combination chemotherapy in treating patients with metastatic or recurrent head and neck cancer

Conditions: Head and Neck Cancer

Summary: rationale: drugs used in chemotherapy use different ways to stop tumor cells from dividing so they stop growing or die. combining more than one drug may kill more tumor cells. purpose: phase ii trial to study the effectiveness of combination chemotherapy in treating patients who have metastatic or recurrent head and neck cancer.

objectives: * determine the overall survival of patients with metastatic or recurrent squamous cell carcinoma of the head and neck treated with paclitaxel, cisplatin, and fluorouracil. * determine response (unconfirmed, confirmed, complete, and partial) and time to treatment failure in patients with measurable disease treated with this regimen. * determine the toxic effects of this regimen in these patients. outline: patients receive paclitaxel iv over 3 hours followed by cisplatin iv over 30 minutes on day 1 and fluorouracil iv over 24 hours on days 1-4. courses repeat every 21 days in the absence of disease progression or unacceptable toxicity. patients achieving complete response (cr) receive 3 additional courses beyond cr. patients are followed every 3 months for 1 year and then every 6 months for 2 years. projected accrual: a total of 65 patients will be accrued for this study within 12 months.

Eligibility criteria:
disease characteristics: * histologically confirmed squamous cell carcinoma of the head and neck * metastatic at diagnosis or persistent, metastatic, or recurrent after surgery and/or radiotherapy * relapse after prior induction or adjuvant therapy allowed * no newly diagnosed nonmetastatic disease * measurable or nonmeasurable disease patient characteristics: age: * 18 and over performance status: * zubrod 0-1 life expectancy: * not specified hematopoietic: * not specified hepatic: * not specified renal: * creatinine no greater than 1.5 mg/dl or * creatinine clearance at least 50 ml/min other: * not pregnant or nursing * fertile patients must use effective contraception * no grade 2 or greater sensory neuropathy * no other prior malignancy within the past 5 years except adequately treated basal cell or squamous cell skin cancer, carcinoma in situ of the cervix, or stage i or ii cancer in complete remission prior concurrent therapy: biologic therapy: * no concurrent biologic therapy chemotherapy: * see disease characteristics * at least 6 months since prior carboplatin or cisplatin induction or adjuvant chemotherapy * no more than 1 prior induction or adjuvant chemotherapy regimen * no prior chemotherapy for recurrent or newly diagnosed metastatic disease * no other concurrent chemotherapy endocrine therapy: * no concurrent anticancer hormonal therapy radiotherapy: * see disease characteristics * at least 28 days since prior radiotherapy and recovered * no concurrent radiotherapy surgery: * see disease characteristics * at least 28 days since prior surgery and recovered

Keywords: stage iv squamous cell carcinoma of the lip and oral cavity recurrent squamous cell carcinoma of the lip and oral cavity stage iv squamous cell carcinoma of the oropharynx recurrent squamous cell carcinoma of the oropharynx stage iv squamous cell carcinoma of the nasopharynx recurrent squamous cell carcinoma of the nasopharynx stage iv squamous cell carcinoma of the hypopharynx recurrent squamous cell carcinoma of the hypopharynx stage iv squamous cell carcinoma of the larynx recurrent squamous cell carcinoma of the larynx stage iv squamous cell carcinoma of the paranasal sinus and nasal cavity recurrent squamous cell carcinoma of the paranasal sinus and nasal cavity