[Palliative antineoplastic chemotherapy of patients with head and neck tumors]

Abstract

Palliative chemotherapy in patients with head and neck cancer after failing previous treatment is generally accepted clinically although real benefits for patients remain controversial. Proponents may feel morally obliged to offer patients this remaining opportunity for further care. Additionally, palliative therapy may have certain favorable effects for the patient, such as pain relief and facilitating swallowing. Critics note that there is no prolongation of survival time and patients may experience a decreased quality of life because of side effects due to treatment. In these cases antineoplastic drugs cannot be targeted to the tumor region because patients develop a poor tissue vascularity in areas previously radiated or operated upon. Our department has treated 34 patients with advanced cancers, using single drug therapy with carboplatin in 19 patients and methotrexate in 6 patients and combination chemotherapy with cisplatin and methotrexate in 9 patients. The average survival time following palliative chemotherapy was 6.5 months. When patients experienced serious side effects and decreased quality of life, therapy was discontinued. However, two patients with inoperable tumors of the epipharynx undergoing this form of treatment survived for 18 and 24 months respectively, with an improved quality of life, as detailed in this report. The best palliative results were achieved in patients with tumors of the nasopharynx, nose and paranasal sinuses when compared to other head and neck localizations. These results were independent of the T-stage but were especially notable in patients without tumor involvement in neck lymph nodes or N1 tumors.(ABSTRACT TRUNCATED AT 250 WORDS)