Docetaxel, cisplatin and 5-fluorouracil induction chemotherapy followed by chemoradiotherapy or chemoradiotherapy alone in stage III–IV unresectable head and neck cancer

Abstract

The addition of ICT to CRT did not show any advantage in our phase II trial, while the incidence of adverse events increased. The three deaths as a consequence of ICT call attention to the importance of adequate patient selection if ICT is considered.

Outcomes of Induction Chemotherapy for Head and Neck Cancer Patients

“…18,19 The 3-year overall (43% vs 55%) or progression-free (41% vs 50%) survival rates were not significantly different in the induction CT with docetaxel + CCRT and CCRT groups. 19 PARADIGM and DECIDE were phase III trials that were closed to accrual and did not fulfill the predicted accrual targets.…”

“…18,19 The 3-year overall (43% vs 55%) or progression-free (41% vs 50%) survival rates were not significantly different in the induction CT with docetaxel + CCRT and CCRT groups. 19 PARADIGM and DECIDE were phase III trials that were closed to accrual and did not fulfill the predicted accrual targets. In both trials, docetaxel-based induction CT did not improve survival; 7,8 however, a randomized phase II trial by Paccagnella et al 20 demonstrated that adding docetaxel-based induction CT to CCRT increased the rate of complete radiological response compared with CCRT alone, and the trend favored progression-free and overall survival after docetaxel inclusion.…”

“…In most studies on induction CT, oropharyngeal cancer (a nonoral cavity cancer) was the most prominent cancer, and on an average, more than 50% of head and neck cancer cases were of oropharyngeal cancer. 5–7,19,24 This may explain why survival did not significantly differ between the docetaxel + CCRT and CCRT groups. 7,8,25 In our study, among nonoral cavity cancer patients who tolerated docetaxel + CCRT, no significant difference in survival was evident between the docetaxel + CCRT and CCRT groups.…”

“…We considered the ITT approach in our study; if head and neck cancer patients without distant metastasis received induction CT alone, then the patients would have dropped out after initial treatment because of an increase in the adverse events. 7,8,18,19 The ITT approach provides unbiased comparisons among treatment groups and is used to avoid the effects of crossing over and dropping out, both of which may alter the outcomes of initial treatment assigned to the treatment groups. Overall, docetaxel- or platinum-based induction CT was inferior to CCRT in all-cause and head and neck-related death in our analysis (Figure 1A, B).…”

Downregulation of miRNA-26b inhibits cancer proliferation of laryngeal carcinoma through autophagy by targeting ULK2 and inactivation of the PTEN/AKT pathway

“…According to the latest research, though novel surgical treatments, chemotherapy drugs, more advanced radiotherapy means and targeted drugs have been applied in treating laryngocarcinoma in the last 30 years, the overall survival of patients with laryngocarcinoma has not improved, instead, it even shows a decreasing trend, which is ~50%; and that of advanced stage laryngocarcinoma is even as low as 30-40%. The overall therapeutic effects are unsatisfying (3).…”