Alpha-2B-interferon in head and neck cancer

Alpha-2b-interferon had demonstrated a different activity in advanced refractory of relapsing solid tumors and in particular tumors of head and neck. Because of the reported synergism between interferon and different treatment modalities [including cytotoxic agents], a trial of 31 patients with advanced head and neck cancer was conducted utilizing alpha-2b-interferon [interon A]. Interon A was given as a single [in 7 patients] or in combination with other treatment modalities [in 24 patients]. Administration of interon A was either perilesionally [in 17 patients] or intravenously [in 14 patients] in a dose of one million IU. daily for a planned minimum 4 weeks, then 3 times weekly for 3 weeks. The overall remission [partial and complete] was seen in 13/24 [54%] of patients in the combined treatment group and in 2/7 [28.6%] of patients treated with interferon alone. Response duration was 7 and 44 months, respectively. The most common side effects were flu-like symptoms; fatigue and pyrexia which could be ameliorated by acetaminophen. Statistically, there was no significant difference observed between patients treated by interferon alone or in combination with other treatment modalities, as regard response rate; duration of response or effect of prior therapy, yet, considering the high risk characteristics of this group of patients [61% relapse or refractory after prior therapy, and 39% had advanced disease], in addition to the small-sized sample of this group; these preliminary results suggest that interferon may have an active role in treatment of head and neck cancer patients with an acceptable degree of toxicity

value of booster dose for local residual primary lesion of nasopharyngeal carcinoma

Twenty two patients with nasopharyngeal carcinoma with a documented residual lesion in the nasopharynx at 66 GY [clinically and/or pathologically] were studied. Booster dose 10-14 Gy was given in 14 patients while 8 patients did not receive the boost. The value of booster dose was reflected favourably upon the overall response rate and its duration and on the disease free survival rates. Among 14 patients received the boost, 3 have partial remission for a median 18 months and 11 patients have complete remission for a median 30 months. For the 8 patients left unboosted only one patients maintained a complete remission for 30 months; 3 patients have partial remission for a median 15 months and 4 patients with stationary disease for 12 months. The total local recurrence, rates of both groups of patients were 21.4% [3/14] and 87.5% [7/8], respectively. Local recurrence was relatively high among patients with primary well to moderately differentiated epitheliomas than poorly to un-differentiated ones, even in boosted patients. The disease-free survival rate for the whole study group was 50% at 36 months with a median follow-up period and overall survival of 27 and 14.5 months for the patients with and without primary boosting, respectively. Disease free-survival rate was significantly higher for the boosted than non-boosted patients [80% and 13% at 20 months, respectively], and with 73% disease free-survival at 36 months for the boosted patients. From this-study, we believe that booster dose for residual lesion in the nasopharynx [better pathologically proved] is necessary to improve the local control and the disease-free survival of patients