Clinical Effect of Cisplatin (NK-801) on Head and Neck Cancer

Twenty-one patients with head and neck cancer were treated withcis-diamminedichloroplatinum (cisplatin). Two kinds of regimenwere used in this study: a low-dose regimen (7 mg/m² 3-hr intravenous(i.v.) infusion or an intraarterial (i.a.) push injection, days1–5, q 3 wk) and a high-dose regimen (50 mg/m² 24-hr i.v.infusion or a 2-hr i.a. infusion, q 3 wk). Nine patients weretreated before radiotherapy or surgery for stage III or IV diseaseand the remaining 12 were treated for recurrent or metastaticdisease. The tumors were 18 squamous cell carcinomas, 2 adenocarcinomasand one adenoid cystic carcinoma. The overall response rate was 35% with two complete responsesand five partial responses ( 50% regression). With the high-doseregimen there were two complete responders and four partialresponders, while in the low-dose regimen only one partial responsewas observed. There was no difference in therapeutic effectdue to the route of administration. Toxicity was minimal: no patients had creatinine levels of >2mg/dl; there were leucopenia (<3,000/mm³) in one patient,nausea and vomiting in 62%, and minimal hearing impairment intwo patients. The most impressive point regarding this agent is that responsesare complete in some patients with long periods of remission. We conclude that cisplatin is an effective new agent for squamouscell carcinoma of the head and neck. Further studies shouldbe performed for the purpose of developing new combinationsof chemotherapeutic agents that include this one.