EARLY DEATH DURING INITIAL CHEMOTHERAPY OF SQUAMOUS-CELL CARCINOMA OFTHE ORO-PHARYNX OR HYPOPHARYNX

Neoadjuvant chemotherapy produces high response rates in squamous cell carcinoma of the head and neck without increasing the survival time. Furthermore authors have observed a death rate of about 5% (up to 10%) during chemotherapy. A series of patients with an ore- or hypo-pharyn x cancer, were retrospectively divided into two groups on the basis of a short (less than or equal to 2 months) or long (greater than or equ al to 2 years) survival time. Clinical, tumoral and usual biological d ata from either group were compared By univariate analysis, obesity in dex, hemoglobin, albumin concentrations and mononuclear cell counts we re lower in patients with a short survival time compared with those in the other group. On the contrary, polymorphonuclear cell and platelet counts were higher. Infection appeared to be mole frequent for patien ts with a poor prognosis without being entirely responsible for entire ly death. By multivariate analysis, obesity index and platelet count w ere both independent variables associated with prognosis. These result s call for further investigation of cardiac function, inflammatory nut ritional and immunological status of patients with squamous cell carci noma of the head and neck who were given initial chemotherapy, particu larly Cisplatin and Fluorouracil.