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International Journal of Clinical Oncology
Published in: International Journal of Clinical Oncology 7/2019

01-07-2019 | Neutropenia | Original Article

Induction TPF chemotherapy followed by CRT with fractionated administration of cisplatin in patients with unresectable locally advanced head and neck cancer

Authors: Susumu Okano, Tomohiro Enokida, Takuma Onoe, Yosuke Ota, Atsushi Motegi, Sadamoto Zenda, Tetsuo Akimoto, Makoto Tahara

Published in: International Journal of Clinical Oncology | Issue 7/2019

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Abstract

Background

In treatment of locally advanced squamous cell carcinoma of the head and neck (SCCHN), the use of docetaxel, cisplatin, and 5-fluorouracil (TPF) followed by high-dose cisplatin chemoradiotherapy (CRT) carries concerns over toxicity. We evaluated the feasibility of TPF as induction chemotherapy (IC) to Japanese patients and the tolerability of CRT with fractionated administration of cisplatin after IC.

Methods

Patients with unresectable stage III, IV SCCHN received IC followed by CRT. IC consisted of three 3-week cycles of docetaxel 70–75 mg/m2 on day 1, cisplatin 70–75 mg/m2 on day 1, and 5-fluorouracil 750 mg/m2 on days 1–5. Patients subsequently received IMRT concomitant with fractionated administration of cisplatin (20 mg/m2) on days 1–4, repeated every 3 weeks. The primary endpoint was completion of the three cycles of IC.

Results

Forty-eight patients were enrolled. The IC treatment completion rate was 85%. Grade 3–4 toxicities of TPF were neutropenia (79%) and febrile neutropenia (15%). Thirty-eight patients (79%) achieved a response after IC. Forty patients subsequently underwent CRT. Thirty-three patients (83%) completed the planned cycles of fractionated administration of cisplatin, but seven (18%) did not. Grade 3–4 toxicities during CRT were neutropenia (23%), mucositis (53%), and dysphagia (33%). With a median follow-up of 36.1 months, 3-year overall survival was 65%.

Conclusion

TPF IC is feasible and CRT with fractionated administration of cisplatin after IC is tolerable. IC followed by CRT appears to be a useful and safe sequential treatment. (Trial registration no. UMIN000024686).
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Metadata
Title
Induction TPF chemotherapy followed by CRT with fractionated administration of cisplatin in patients with unresectable locally advanced head and neck cancer
Authors
Susumu Okano
Tomohiro Enokida
Takuma Onoe
Yosuke Ota
Atsushi Motegi
Sadamoto Zenda
Tetsuo Akimoto
Makoto Tahara
Publication date
01-07-2019
Publisher
Springer Singapore
Published in
International Journal of Clinical Oncology / Issue 7/2019
Print ISSN: 1341-9625
Electronic ISSN: 1437-7772
DOI
https://doi.org/10.1007/s10147-019-01418-w

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