Induction chemotherapy with dose-modified docetaxel, cisplatin, and 5-fluorouracil in Asian patients with borderline resectable or unresectable head and neck cancer

• Main Authors: Hung-Ming Wang, Chien-Yu Lin, Chia-Hsun Hsieh, Cheng-Lung Hsu, Kang-Hsing Fan, Joseph Tung-Chieh Chang, Shiang-Fu Huang, Chung-Jan Kang, Chun-Ta Liao, Shu-Hang Ng, Tzu-Chen Yen
• Format: Article
• Language: English
• Published: Elsevier 2017-03-01
• Series: Journal of the Formosan Medical Association
• Subjects: Asia; docetaxel; head and neck cancer; induction chemotherapy; resectability
• Online Access: http://www.sciencedirect.com/science/article/pii/S0929664616300158

Significant ethnic differences in susceptibility to the effects of chemotherapy exist. Here, we retrospectively analyzed the safety and efficacy of induction chemotherapy (ICT) with dose-modified docetaxel, cisplatin, and 5-fluorouracil (TPF) in Asian patients with borderline resectable or unresectable head and neck squamous cell carcinoma (HNSCC). Methods: Based on the incidence of adverse events that occurred during daily practice, TPF90 (90% of the original TPF dosage; docetaxel 67.5 mg/m2 on Day 1, cisplatin 67.5 mg/m2 on Day 1, and 5-fluorouracil 675 mg/m2 on Days 1–5) was used for HNSCC patients who were scheduled to receive ICT TPF. Results: Between March 2011 and May 2014, 52 consecutive patients with borderline resectable or unresectable HNSCC were treated with ICT TPF90 followed by concurrent chemoradiotherapy. Forty-four patients (84.6%) received at least three cycles of ICT TPF90. The most commonly observed Grade 3–4 adverse events included neutropenia (35%), anemia (25%), stomatitis (35%), diarrhea (16%), and infections (13.5%). In an intention-to-treat analysis, the complete and partial response rates after ICT TPF90 were 13.5% and 59.6%, respectively. The complete and partial response rates following radiotherapy and salvage surgery were 42.3% and 25.0%, respectively. The estimated 3-year overall survival and progression-free survival rates were 41% [95% confidence interval (CI): 25–56%] and 23% (95% CI: 10–39%), respectively. The observed median overall survival and progression-free survival were 21.0 months (95% CI: 13.3–28.7 months) and 16.0 months (95% CI: 10.7–21.3 months), respectively. Conclusion: TPF90 is a suitable option for Asian patients with borderline resectable or unresectable HNSCC who are scheduled for ICT.