UNKNOWN PRIMARY-CARCINOMA - RANDOMIZED STUDIES ARE NEEDED TO IDENTIFYOPTIMAL TREATMENTS AND THEIR BENEFITS

This is a retrospective review of 101 patients with unknown primary ca rcinoma (UPC) treated between 1989 and 1994, on whom data were collect ed prospectively. 92 patients received platinum-based chemotherapy and 9 had single agent 5-fluorouracil (5-FU). In the platinum group, an o bjective response rate of 37.2% was seen, with a median duration of 4. 5 months (range 1.9-17.5). There were no responses with 5-FU alone, wh ile median survival was 6.4 months and was not different from the plat inum group (P = 0.09). Considerable symptomatic resolution was noted, although the contribution of chemotherapy alone to this is difficult t o define. The impact of tumour response on quality of life and surviva l in UPC requires further elucidation in prospective studies with a (b est supportive care' arm. The superiority of platinum-based treatments reported in selected subgroups cannot be applied to the whole spectru m of UPC. Copyright (C) 1996 Elsevier Science Ltd