TPF (docetaxel, cisplatin, fluorouracil) is the standard chemotherapy used for induction in locally advanced head and neck squamous cell carcinoma (LAHNSCC).Its toxicity limits it to younger patients with good functional status and without significant comorbidity. Since modified TPF (mTPF) demonstrated higher tolerability with similar efficacy in gastric cancer, we tested this scheme on frail patients.From July 2010 to July 2014, the files of the 48 patients treated for LAHNSCC with mTPF in three French institutions were retrospectively collected. mTPF was chosen because of age>70 years, or severe denutrition, or PS>1, or severe comorbidities or after severe toxicity of standard TPF. During the first 4 cycles, 2 patients died, 14 secondary hospitalizations were required and 10 patients stopped treatment due to no lethal toxicity. Two patients died during radiotherapy.The response rate was 83% (19% complete response). With a median follow-up of 15.2 months, 4 patients died during treatment, 8 died of non-head and neck cancer related disorders, 18 progressed (17 deaths) and 18 were free of disease. The median overall survival was 18.5 months (95% IC: 16.9-30.0). mTPF is effective in terms of response rate compared with the standard TPF and could become a new option in induction for frail patients with LAHNSCC.

To assess the contribution of multidisciplinary team meetings (MTM) on vestibular schwannoma management as well as to (1) compare professional compliance to national guidelines and (2) study the percentage of loss to follow-up in cases of conservative management by radiologic observation. A retrospective descriptive study of MTMs held between January 2011 and May 2013 in a tertiary referral center. Patients were classified in three groups according to the MTM decision (observation, surgery or radiotherapy). A total of 363 cases were discussed during the study period (29 months). One hundred and ninety-four decisions (53.4%) were for conservative management with radiologic observation, 130 (35.8%) for surgery, and 39 (10.7%) for radiation therapy. The sex ratio was 0.94, and the patients had a median age of 59 years (range 18-86 years). Most of the vestibular schwannomas (74.2%) were small (stages I and II). Global concordance between the MTM decision and International Radiosurgery Association guidelines was 88.7%. Twenty-three percent of the 104 files that were discussed in MTMs between January 2011 and July 2012, for which conservative management was decided, were lost to follow-up by 18 months. Management of vestibular schwannoma remains controversial, but it usually depends on the evolutive status. MTMs improve practice and facilitate the creation and maintenance of local registries. Future studies in MTMs are warranted to evaluate the benefit and evaluated if MTM could optimize long-term follow-up, limiting loss to follow-up in the observation of vestibular schwannomas that may be evolutive.