ORAL 5-FU ALTERNATIVES FOR THE TREATMENT OF HEAD AND NECK-CANCER

The common clinical presentations of head and neck cancer include earl y (stage I or II) disease, locally or regionally advanced (stage III o r IV, M0) disease, and recurrent or metastatic disease (< 5% of patien ts). Patients with stage I-II disease are usually cured following surg ery oi radiotherapy; those with more advanced disease, however, will b enefit from chemotherapy-either as induction treatment to avoid surger y and preserve the larynx, or as simultaneous chemoradiotherapy for pa tients with locoregionally advanced disease; patients presenting with metastatic disease and those with recurrent disease receive chemothera py as the primary treatment modality. The clinical experience,with ora l chemotherapy in head and neck cancer patients is limited, partly bec ause of the anatomic location of the disease and complications of loca l treatment. At the University of Chicago, several regimens that inclu de oral chemotherapy have been studied, including infusional 5-flourou racil/oral hydroxyurea/radiotherapy, and eniluracil/oral 5-FU/radiothe rapy. These trials and others assessing oral agents in the treatment o f patients with head aad neck cancer will be discussed.