[Taxan induction chemotherapy and concomitant chemoradiotherapy with cisplatin in patients with locally advanced head and neck cancer--early results]

Abstract

The growing number of patients with head and neck cancer is a reason to search for new effective treatment strategies. Results of treatment for locally advanced squamous cell head and neck cancer with surgery and/or radiotherapy are still unsatisfactory. During last decade concomitant chemoradiotherapy became a new standard in this group of patients. The treatment method is charged of high toxicity and real therapeutic advantages are obtained by limited number of patients. Intensive clinical investigations on novel therapeutic strategies are in progress. One of them is the combination of induction chemotherapy with taxan (TPF) and concomitant chemoradiotherapy join with cisplatin. The aim of the study was to estimate the treatment tolerance and early term results with combination of induction chemotherapy with TPF and concomitant chemoradiotherapy join with cisplatin in patients with locally advanced, squamous cell carcinoma of head and neck.

Material and methods: Patients with locally advanced oropharyngeal and larynx cancer treated in the Institute of Oncology in Bialystok at the Department of Radiotherapy II from latter half of 2009 year were included in the study. The treatment protocol consisted of 3 courses of induction chemotherapy TPF (Taxotere 75 mg/m2, DDP 100 mg/m2, 5-Fluorouracyl 1000 mg/m2 every 3 weeks) and conventionally fractionated radiotherapy (Df=2 Gy, 5 x weekly) to total dose of 66-72 Gy and for neck cervical lymph nodes up to 60-66 Gy with concomitant of cisplatin 100 mg/m2 every 3 weeks. Early reactions were estimated according to EORTC/RTOG scales, and chemotherapy tolerance was evaluated according to the CTC scale. Twelve patients with homogenous criteria were included in the study.

Results: The treatment tolerance was acceptable. However several adverse reactions were present. The main adverse effect was the extensive mucosal reaction. Neutropenia and anemia were also observed in most of the patients. Some patients complained of diarrhea, vomiting and nausea in mild or moderate intensity which were persisted temporarily.

Conclusions: Induction chemotherapy TPF and concomitant radiochemotherapy with cisplatin in patients with locally advanced head and neck cancer in III-IV clinical stages came out as the treatment of high efficacy.