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HEAD & NECK CANCER
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Regimen/Number Of Patients |
Drug Dose and Route |
Leukopenia/ Neutropenia Toxicity |
Anemia Toxicity |
Other Grade III-IV Toxicities |
Emetogenic Potential |
Consequences of Adverse Event(s) |
|
Cisplatin 5- Fluorouracil (Forastiere AA, et al, J Clin Oncol, 1992;10:1245-51
N= 87
|
Cisplatin 100 mg/m2 IV day 1 5-Fluorouracil 1000 mg/m2 / d IV continuous infusion days 1-4 Repeat cycle every 21 days |
Leukopenia Grade III 28% Grade IV 2% Neutropenia Grade III 3.5% Grade IV 5% |
Grade III 5% |
Neutropenic Sepsis 1 % Thrombocytopenia 6% Diarrhea 2% Stomatitis 14% Nausea / Vomiting 8% Peripheral Neuropathy 1% Ototoxicity 4% Renal 9%
|
Day 1- Level 5 Days 2- 4 – Level 2 |
Infectious mortality 1% Cardiac events 7%
|
|
CF (Forastiere AA, et al, J Clin Oncol, 1992;10:1245-51)
N= 86 |
Carboplatin 300 mg/m2 IV day 1 5- Fluorouracil 1000 mg/m2/d IV continuous infusion days 1- 4 Repeat cycle every 28 days |
Leukopenia Grade III 9% Grade IV 25 Neutropenia Grade III 1% Grade IV 1% |
Grade III-IV 14% |
Neutropenic 1% Nausea / Vomiting 6% Thrombocytopenia 13% Diarrhea 2% Stomatitis 15% Renal Toxicity 1% |
Day 1 – Level 5 Days 2 – 4- Level 2 |
Infection mortality 15
|
|
Docetaxel- Cisplatin (Glisson BS, et al, J Clin Oncol, 2002;20:1593-99)
N= 36
|
Docetaxel 75 mg/m2 IV day 1 Cisplatin 75 mg/m2 IV day 1 Repeat cycle every 21 days Appropriate premedications listed in Section 2, Commonly Used Premedicaion Regimens
|
Neutropenia Grade III 9% Grade IV 71%
|
Grade III 14%
|
Febrile Neutropenia 6% Infection 17 % Thrombocytopenia (Grade IV) 3% Asthenia 25% Nausea 11% Vomiting 8% Pulmonary 8% Allergy 8% Diarrhea 6% Stomatitis 3% Neurosensory 3% Neuromotor 3 %
|
Day 1 – Level 5 |
|
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TIC (Shin DM, et al, Cancer 2001;91:1316-23)
N= 55
|
Paclitaxel 175 mg/m2 IV over 3 hours day 1 Ifosfamide 1000 mg/m2 /d IV over 2 hours days 1-3 Mesna 200 mg/m2 befor ifosfamide and 400 mg/m2 after ifosfamide days 1-3 Caboplatin targeted to an AUC of 6 (Calvert formula) as a 30-minute IV infusion day 1 Repeat cycle every 21 – 28 Appropriate premedication listed in Section2, Commonly Used Premedication Regimens
|
Neutropenia Grade III-IV 92% |
|
Neutropenic Fever (Grade V *) 2 % Fatigue (Grade III) 6% Nausea / Emesis (Grade III) 4% Peripheral Sensory Neuro pathy (Grade III) 2 % Myalgia / Arthralgia (Grade III) 2 % Nephrotoxicity (Grade III) 2% Anorexia (Grade III) 4%
NCIC Criteria Scale, Grade 0-V
|
Day1- Level 5 Days 2 – 3- Level 3 |
1 septic death 13% of patients required RBC transfusions 7% of patients required platelet transfusions ANC nadir median days Toxic effects are cumulative and usually occurred after 3 -4 courses of treatment |
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HEAD & NECK CANCER (continued ) : Page 2
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|
Regimen/Number Of Patients |
Drug Dose and Route |
Leukopenia/ Neutropenia Toxicity |
Anemia Toxicity |
Other Grade III-IV Toxicities |
Emetogenic Potential |
Consequences of Adverse Event(s) |
|
TIP (Shin DM, et al, J Clin . Oncol, 1998;16: 1325-30)
N= 52
|
Paclitaxel 175 mg/m2 over 3 hours on day 1 Ifosfamide 1000 mg/m2 /d over 2 hours days 1-3 Mesna 400 mg/m2 befor ifosfamide and 200 mg/m2 IV, 4 hr after ifosfamide days 1-3 Cisplatin 60 mg/m2 IV day 1 Repeat cycle every 21 – 28 days Appropriate premedication listed in Section2, Commonly Used Premedication Regimens
|
Neutropenia Grade III-IV 90% |
|
Neutropenic Fever 27% Pneumonia 8% Nausea/ Vomitting (Grade III) 6% Anorexia (Grade III) 4% Fatigue 15 % Peripheral Neuropathy (Grade III) 6% Renal Toxicity (Grade III) 2% Mucositis (Grade III) 2% Orthostatic Hypotension 4%
|
Day 1 – Level 5 Day 2, 3- Level 3 |
Hospitalization secondary to pneumonia 15 % Blood transfusions 11% Discontinued treatment due to toxicity 2 % |