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Indian Journal of Medical and Paediatric Oncology
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Year : 2002  |  Volume : 23  |  Issue : 1  |  Page : 13-16

Alpha interferon-2b as a modulator of ifosfamide plus cisplatin induction chemotherapy for advanced head & neck.

Department of Medical Oncology, Tata Memorial Hospital, Mumbai

Correspondence Address:
VR Pai
Department of Medical Oncology, Tata Memorial Hospital, Mumbai

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Source of Support: None, Conflict of Interest: None

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We have reported a response rate of 65.7 per cent with ifosfamide and cisplatin combination in the treatment of advanced head and neck cancer.6 there have been promising new preliminary data to show that interferon with combination with chemotherapy can produce good response rate in patients with advanced head and neck cancer. Methods: All the patients with locally advanced or metastatic squamous cell carcinoma of the head and neck (SCCHN) are entered in this study. Eligible patients had to have histologically proven SCCHN, no prior chemotherapy, measurable disease, WHO performance status 0-2 normal renal, liver function, WBC greater than 4000, platelet count greater than 100,000 and Haemoglobin greater than 10gm. Treatment Plan: All patients were treated with ifosfamide 1.5 gm/m2 IV infusion D1 to D5, inj. mesna 400 mg iv push at 0, 4, 8 hours on D1 to D5, inj cisplatin 20 mg infusion on D1 to D5 and inj alpha interferon-2b 3 mu subcutaneously on D1 to D5. Tab paracetamol 500 mg PO was given thirty minute prior to alpha-interferon therapy. The cycle was repeated every four weeks and such three cycles were administered. After completion of three cycles of chemotherapy, patients were assessed for response. Patients with complete response (CR), partial response (PR) and stable disease were evaluated for radiotherapy/surgery, whereas patients with progressive disease were treated symptomatically. Results: Between 1993 and 1994, 75 patients of advanced head and neck cancer were entered in the study. There were 67 males and 8 females and their median age was 50 (12-72) years. At the end of three cycles, 53 patients were evaluable for chemotherapy response. We have observed 9 CR, 30 PR and overall response was 73.6 percent. The median duration of response was 6 (1 to 36) months. Adverse effects of chemotherapy were generally well tolerated and reversible. All patients experienced nausea, vomiting, alopecia and flu-like syndrome. There was no dose limiting haematological toxicity. Conclusion: In the current study, the overall response rate is 39/53 (73.6 per cent), which is better than our previous (response rate 65.71 per cent) study in which ifosfamide with cisplatin was used. We conclude that the alpha interferon-2b improved response rate of combination of cisplatin and ifosfamide in patients with advanced head and neck cancer, without much toxicity.

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