The Efficacy of an Induction Chemotherapy Combination with Docetaxel, Cisplatin, and 5-FU Followed by Concurrent Chemoradiotherapy in Advanced Head and Neck Cancer.
- Author:
Jae Sook AHN
1
;
Sang Hee CHO
;
Ok Ki KIM
;
Joon Kyoo LEE
;
Deok Hwan YANG
;
Yeo Kyeoung KIM
;
Je Jung LEE
;
Sang Chul LIM
;
Hyeoung Joon KIM
;
Woong Ki CHUNG
;
Ik Joo CHUNG
Author Information
1. Department of Hemato-Oncology, Chonnam National University Medical School, Gwangju, Korea. sh115@chollian.net
- Publication Type:Original Article
- Keywords:
Head and neck neoplasms;
Radiotherapy;
Docetaxel;
Combination chemotherapy
- MeSH:
Aged;
Carcinoma, Squamous Cell;
Chemoradiotherapy*;
Cisplatin*;
Disease-Free Survival;
Drug Therapy, Combination;
Fluorouracil*;
Follow-Up Studies;
Head and Neck Neoplasms*;
Head*;
Hematoma, Subdural;
Humans;
Induction Chemotherapy*;
Neck;
Neutropenia;
Pneumonia;
Radiotherapy;
Thrombocytopenia
- From:Cancer Research and Treatment
2007;39(3):93-98
- CountryRepublic of Korea
- Language:English
-
Abstract:
PURPOSE: This study was performed to determine the feasibility and safety of the use of induction chemotherapy combined with docetaxel, cisplatin, and 5-fluorouracil (TPF) followed by concurrent chemoradiation therapy for locally advanced squamous cell carcinoma of the head and neck (SCCHN). MATERIALS AND METHODS: The patients, that were initially not treated for locally advanced SCCHN, underwent three cycles of induction chemotherapy every 3 weeks at a dose of 70 mg/m2 docetaxel D1, 75 mg/m2 cisplatin D1, 1000 mg/m2 5-FU D1-4, and subsequently received concurrent chemoradiation therapy. RESULTS: Forty-nine patients were enrolled in this study and forty-three of the patients completed the treatment. The median duration of follow-up was 18 months (range, 6~39 months). All of the patients had stage III (26.5%) or IV (73.5%) squamous cell carcinoma. After sequential therapy, a complete response and partial response was seen in 28 (65.2%) and 13 (30.2%) patients, respectively. The overall response rate was 95.4%. Overall survival and progression-free survival (PFS) at 2 years were 88.7% and 69.7%, respectively. Grade 3~4 neutropenia occurred in 42.2% of the patients and grade 4 thrombocytopenia in 1 cycle (0.7%). Two patients (4.1%) died during the induction chemotherapy due to pneumonia and a subdural hemorrhage, respectively. The group of patients over 65 years of age showed a significant lower dose intensity than that of patients under 65 years of age, but PFS was not significantly different between two groups (p=0.105). CONCLUSION: TPF induction chemotherapy followed by concurrent chemoradiotherapy showed a high level of CR and moderate treatment-induced toxicity. Adequate dose modification in elderly patients should be considered to maintain efficacy and avoid treatment-related toxicity.
