RANDOMIZED STUDY OF HIGH DOSES OF VITAMIN C PLUS CHEMOTHERAPY VERSUS CHEMOTHERAPY ALONE IN PATIENTS WITH ADVANCED AND RECURRENT HEAD AND NECK CANCER

Abstract

Head and neck cancer accounts for nearly 5% of the total cancer incidence in USA. The median survival for patients with locally recurreJ).t or disseminated head and neck cancer is 6 months, 20% of them will survive for one year. The cytotoxic combination chemotherapy regiinen (cisplatin plus 5- fluorouracil) has been used as a standard palliative measure for locally recurrent and metastatic disease. Vitamin C at high concentrations showed a fairly cytotoxic effect and it could potentiate the growth inhibitory effect of cisplatin and 5- fluorouracil. The aim of our work was to evaluate the administration of high doses of vitamin C concomitantly with the standard highly effective cytotoxic chemotherapy regimen which is cisplatin plus 5-fluorouracil.

The study included 50 patients with histologically proved squamous cell carcinoma of the head and neck. They were randomized to receive either cisplatin plus 5-fluorouracil or cisplatin plus 5-fluorouracil with high doses of vitamin C. Their ages ranged between 21-65 years (median 47) with a male to female ratio of 3.1:1. Fourty cases (80%) were located in the larynx and oral cavity and thirty three cases underwent radical surgery while the remaining seventeen cases were found to be irresectable. Ninety percent (45 cases) of our cases had local and cervical metastasis.