Dose-dense TPF induction chemotherapy for locally advanced head and neck cancer: a phase II study

BMC Cancer

Ming-Hsul Tsai¹  Chun-Hung Hua¹  Chen-Yuan Lin²  Ching-Chan Lin²  Ming-Yuh Lein²  Ching-Yun Hsieh²  Yao-Ching Wang³  Yin-Jun Lin³  Shih-Neng Yang³ 

[1] Department of Otorhinolaryngology, China Medical University Hospital, China Medical University;Division of Hematology and Oncology, Department of internal medicine, China Medical University Hospital, China Medical University;Division of Radiation Oncology, China Medical University Hospital, China Medical University;

关键词: Head and neck cancer;    Docetaxel;    Cisplatin;    Fluorouracil;    Dose-dense chemotherapy;    Induction chemotherapy;   

DOI  :  10.1186/s12885-020-07347-6

来源: DOAJ

【 摘 要 】

Abstract Background Phase 3 studies suggest that induction chemotherapy (ICT) of cisplatin and 5-fluorouracil plus docetaxel (TPF) is effective but toxic for patients with squamous-cell carcinoma of the head and neck (SCCHN). Dose-dense chemotherapy may yield favorable outcomes compared with standard-dose chemotherapy, yet the optimal induction regimen remains undefined. We assessed the efficacy and tolerability of biweekly dose-dense TPF ICT in patients with SCCHN. Methods In this prospective phase II study, We enrolled patients with stage III/IV (AJCC 7th edition) unresectable squamous cell carcinoma of head and neck cancer. Patients received dose-dense TPF (ddTPF) with cisplatin and docetaxel 50 mg/m2 on day 1, leucovorin 250 mg/m2 on day1, followed by 48-h continuous infusion of 2500 mg/m2 of 5-fluorouracil on day 1 and 2, every 2 weeks for 6 cycles followed by radiotherapy. The primary endpoint was the response rate (RR) after ICT. Results Fifty-eight patients were enrolled from June 2014 to September 2015. Overall RR after ICT was 89.6% [complete response (CR), 31%; partial response (PR), 58.6%]. Grade 3/4 neutropenia, mucositis, and diarrhea incidences were 25.9, 1.7, and 1.7%, respectively. 94.8% of patients completed all treatment courses of ICT without dose reduction. The 3-year overall survival (OS) was 54.3% (95%CI: 39.7 to 66.8%) and progression-free survival (PFS) was 34.3% (95%CI: 22.0 to 46.9%). Multivariate analysis showed that CR after ICT is an independent prognostic factor for OS and PFS. Conclusions Six cycles of ddTPF is an active, well-tolerated induction regimen for patients with SCCHN. The presence of CR after ICT predicted long-term survival. Trial registration ClinicalTrials.gov Identifier: NCT04397341 , May 21, 2020, retrospectively registered.

【 授权许可】

Unknown