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Treatment of unresectable recurrent head and neck carcinoma with 13-cis-retinoic acid and interferon-α. A phase II study

Published online by Cambridge University Press:  29 June 2007

Angelos C. Nikolaou ,
George Fountzilas  and
Ioannis Daniilidis
Angelos C. Nikolaou*
Affiliation:
University Department of Otorhinolaryngology, 1st Department of Internal Medicine (Oncology section), AHEPA Hospital, Aristotle University Medical School, Thessaloniki, Greece.
George Fountzilas
Affiliation:
University Department of Otorhinolaryngology, 1st Department of Internal Medicine (Oncology section), AHEPA Hospital, Aristotle University Medical School, Thessaloniki, Greece.
Ioannis Daniilidis
Affiliation:
University Department of Otorhinolaryngology, 1st Department of Internal Medicine (Oncology section), AHEPA Hospital, Aristotle University Medical School, Thessaloniki, Greece.
*
Address for correspondence: Dr Angelos C. Nikolaou, M.D., University Department of Otorhinolaryngology, AHEPA Hospital, Aristotle University Medical School, Thessaloniki 540 06, Greece. Fax: 0030 31 207 550
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Abstract

Sixteen patients with unresectable recurrent head and neck carcinomas were treated with 13-cis-retinoic acid and interferon-α. All patients had presented with recurrences after having been treated primarily with surgery and radiotherapy, while two of them had also received induction chemotherapy. The site of relapse was strictly locoregional in all cases (only at the primary site in three cases, at the cervical lymph nodes only in four cases and both at the primary site and the neck in the remaining nine cases. Two patients were female, and 14 male, with an age range of 47–72 years (median 61 years). Interferon-α was administered subcutaneously at a dose of 3 X 106 IU every second day. The dose of retinoids was 40 mg per os every day. The duration of treatment was two to 14 months (median seven months). There were two cases of partial response (tumour regression >50 per cent), eight cases of stable disease lasting for three to seven months (median four months) and six cases presented with progressive disease. All patients died after a survival of three to 17 months (median 9.5 months). Toxicity was generally minimal. We believe that the results are not encouraging, but also not disappointing. The fact that toxicity was indeed mild, with not a single case of life-threatening sequellae even after prolonged administration of the two agents, allows us to conclude that an increase of the dose of IFN-α might be more beneficial. Selection of patients with more ‘favourable’ recurrences will give a better chance to the treatment combination to prove its real efficacy. Larger numbers of patients have to be treated and evaluated before definite conclusions can be reached.

Keywords

Head and neck neoplasmsCarcinomaInterferon-alphaRetinoids
Type
Main Articles
Information
The Journal of Laryngology & Otology , Volume 110 , Issue 9 , September 1996 , pp. 857 - 861
Copyright
Copyright © JLO (1984) Limited 1996

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References

Clark, J. R., Frei, E. III. (1989) Chemotherapy for head and neck cancer: Progress and controversy in the management of patients with Mo disease. Seminars of Oncology 16: 44–57.Google Scholar
Clayman, G. L., Liu, F. J., Savage, H. E., Taylor, D. L., Lavedan, P., Buchsbaum, R. M., Pellegrino, C, Trujillo, J. M., Young, G., Schantz, S. P. (1992a) Acute-phase proteins in patients with head and neck cancer treated with interleukin 2/interferon alfa. Archives of Otolaryngology, Head and Neck Surgery 118: 41–47.CrossRefGoogle ScholarPubMed
Clayman, G. L., Young, G., Taylor, D. L., Savage, H. E., Lavedan, P., Schantz, S. P. (1992b) Detection of regulatory factors of lymphokine-activated killer cell activity in head and neck cancer patients treated with interleukin-2 and interferon-α. Annals of Otology, Rhinology and Laryngology 101: 909–915.CrossRefGoogle ScholarPubMed
Crispino, S. (1993) The use of interferon in head and neck cancer: A clinical review. Forum 34: 384–392.Google Scholar
Dmitrovsky, E., Bosl, G. J. (1992) Active cancer therapy combining 13-cis-retinoic acid with interferon-a. Journal of National Cancer Institute 84: 218–219.CrossRefGoogle Scholar
Fierro, R., Johnson, J., Myers, E., Colao, D., Pelch, K., Rust, D., Wagner, R., Whiteside, T., Vlock, D. (1988) Phase-II trial of non-recombinant interferon-a (IFN) in recurrent squamous cell carcinoma of the head and neck (Abstract). Proceedings of the American Society of Clinical Oncology 7: 156.Google Scholar
Fountzilas, G. (1994) Retinoids in the management of head and neck cancer. An update. Journal of Chemotherapy 6(2): 127–138.CrossRefGoogle ScholarPubMed
Knobler, R. M., Trautinger, F., Radaszkiewicz, T. (1991). Treatment of cutaneous T cell lymphoma with a combination of low-dose interferon alfa-2b and retinoids. Journal of the American Academy of Dermatology 24: 247–252.CrossRefGoogle ScholarPubMed
Lippman, S. M., Kavanagh, J. J., Paredes-Espinoza, M., Delgadillo-Madrueno, F., Paredes-Casillas, P., Hong, W. K., Holdener, E., Krakoff, I. H., (1992a) 13-cis-Retinoic acid and interferon-alfa 2a: High activity systemic therapy for squamous cell carcinoma of the cervix. Journal of National Cancer Institute 84: 241–245.CrossRefGoogle Scholar
Lippman, S. M., Parkinson, D. R., Itri, L. M., Weber, R. S., Schantz, S. P., Ota, D. M., Schusterman, M. A., Krakoff, I. H., Gutterman, J. U., Hong, W. K. (1992b). 13-cis-Retinoic acid and interferon-α 2a: Effective combination therapy for advanced squamous cell carcinoma of the skin. Journal of National Cancer Institute 84: 235–241.CrossRefGoogle ScholarPubMed
Nikolaou, A., Fountzilas, G., Themelis, C, Daniilidis, J. (1993). Treatment of unresectable recurrences of the head and neck carcinomas with interferon-α and retinoids (Abstract). Proceedings of the 15th World Congress of Otorhinolaryngology - Head and Neck Surgery, Istanbul, pp. 360.Google Scholar
Richtsmeier, W. J., Koch, W. M., McGuire, W. P., Poole, M. E., Chang, E. H. (1990) Phase I-II study of advanced head and neck squamous cell carcinoma patients treated with recombinant human interferon gamma. Archives of Otolaryngology, Head and Neck Surgery 116: 1271–1277.CrossRefGoogle ScholarPubMed
Rosenberg, S. A., Schwartz, S., Speiss, P. J. (1988) Combination immunotherapy for cancer: synergistic antitumour interactions of interleukin-2 alpha-interferon, and tumour infiltrating lymphocytes. Journal of National Cancer Institute 80: 1393–1397.CrossRefGoogle Scholar
Schantz, S. P., Clayman, G. L., Racz, T., Grimm, E. A., Liu, F. J., Lavedan, P., Taylor, D., Pellegrino, C., Savage, H. (1990) The in vivo biologic effect on interleukin 2 and interferon alfa on natural immunity in patients with head and neck cancer. Archives of Otolaryngology, Head and Neck Surgery 116: 1302–1308.CrossRefGoogle ScholarPubMed
Smith, M. A., Parkinson, D. R., Cheson, B. D., Friedman, M. A. (1992) Retinoids in cancer therapy. Journal of Clinical Oncology 10: 839–864.CrossRefGoogle ScholarPubMed
Tannock, I. F., Browman, G. (1986) Lack of evidence for a role of chemotherapy in the routine management of locally advanced head and neck cancer? Journal of Clinical Oncology 4(7): 1121–1126.CrossRefGoogle ScholarPubMed
Taylor, S. G. (1987) Why has so much chemotherapy done so little in head and neck cancer? Journal of Clinical Oncology 5(1): 1–3.CrossRefGoogle ScholarPubMed
Voravud, N., Lippman, S. M., Weber, R. S., Rodriquez, G. I., Yee, D., Dimery, I. W., Earley, C. L., Von Hoff, D. D., Ki Hong, W. (1993) Phase II trial of 13-cis-retinoic acid plus interferon-α in recurrent head and neck cancer. Investigational New Drugs 11: 57–60.CrossRefGoogle ScholarPubMed