Radiation Therapy With 5-fluorouracil in Head and Neck Cancer

Area of Science:

• Oncology
• Radiotherapy
• Chemotherapy

Background:

• 5-Fluorouracil (5-FU), often with cisplatin, is a key agent in head and neck cancer treatment, used with radiotherapy and surgery.
• Concurrent 5-FU and radiation therapy improves outcomes but elevates risks of acute mucositis, particularly with additional agents.

Purpose of the Study:

• To review the efficacy and toxicity of 5-Fluorouracil (5-FU) based treatment strategies in head and neck cancer.
• To evaluate different administration schedules of 5-FU and cisplatin in combination with radiotherapy.

Main Methods:

• Review of randomized trials investigating concurrent, alternating, induction, and adjuvant chemotherapy with radiotherapy for head and neck cancer.
• Analysis of treatment outcomes including local-regional control, progression-free survival, overall survival, and toxicity.

Main Results:

• Concurrent 5-FU and radiotherapy improves local-regional control and survival but increases mucositis.
• Alternating 5-FU and cisplatin with radiotherapy showed improved survival in unresectable cases.
• Induction chemotherapy with 5-FU and cisplatin may reduce distant metastasis but has not improved local control or survival.

Conclusions:

• Concurrent 5-FU and radiotherapy is effective but toxic.
• Alternating and induction chemotherapy regimens warrant further investigation.
• Optimizing 5-FU based therapies with novel schedules and modulators is crucial for improving the therapeutic ratio in head and neck cancer.