Feasibility and efficacy of chemoradiotherapy with concurrent split‑dose cisplatin after induction chemotherapy with docetaxel/cisplatin/5‑fluorouracil for locally advanced head and neck cancer

Abstract

Chemoradiotherapy (CRT) with concurrent high-dose cisplatin (CDDP) is a standard treatment for locally advanced squamous cell carcinoma of the head and neck (LA-SCCHN). Docetaxel plus CDDP and 5-fluorouracil (TPF) induction chemotherapy (ICT) prior to CRT is considered for patients at high risk of distant metastases. The purpose of the current study was to evaluate the feasibility and efficacy of CRT with split-dose CDDP after TPF-ICT for LA-SCCHN. A total of 21 LA-SCCHN patients treated with TPF-ICT followed by concurrent CRT with split-dose CDDP between January 2011 and December 2017 were retrospectively analysed. The patients' characteristics were i) median age 66 years (48-75 years); ii) male/female, 21/0; iii) performance status 0-1/2, 20/1; iv) larynx/hypopharynx/oropharynx/oral cavity, 4/8/8/1 and v) clinical stage III/IV, 3/18. The numbers of TPF-ICT cycles 1/2/3 were 2/3/16. Median cumulative doses of CDDP in TPF-ICT and CRT were 180.0 and 206.7 mg/m 2 , respectively. All patients completed 70 Gy RT. The complete response rate was 76.2%. At a median follow-up of 51.5 months, median PFS and OS were not reached and 65.5 months, respectively. The most common grade 3 or worse toxicities during CRT-ICT were stomatitis (48%), dysphagia (21%), anorexia (17%) and leukopenia (14%). However, no grade 2 or worse nephrotoxicity, neurotoxicity or ototoxicity was observed. The results demonstrated that concurrent CRT with split-dose CDDP after TPF-ICT is feasible and effective for LA-SCCHN.

Comparative study on hemato- and nephrotoxicity profile of weekly versus every 3-weekly cisplatin dosage during induction chemotherapy in locally advanced head neck squamous cell carcinoma

“…Anemia is one of the commonest complications in cisplatin chemotherapy [38] in both weekly and 3-weekly groups of patients in concurrent setting [37]. In our study, there was a greater fall of RBC count in weekly cisplatin group as compared to 3-weekly group.…”

“…We observed thrombocytopenia in 14.8% cases, showing greater fall in the weekly group as compared to 3-weekly regimen with extremely significant statistical difference. Kogo M, et al [32] reported thrombocytopenia in 10.2% cases and Yokota T et al [38] reported in 85% cases receiving IC with docetaxel plus ciplatin and 5FU as combination chemotherapy. In another study, Chen JX et al [35] reported thrombocytopenia in both the groups (P < 0.05, P < 0.01) similar to studies by Furqan et al [37] and Karim et al [23].…”

Quality of life and tracheostomy influence in successfully treated hypopharyngeal cancer: A case report

“…No complaints or complications involving the tracheostomy were observed. The clinical trials that support the use of induction chemotherapy for hypopharyngeal cancer are not consistent as they have failed to exhibit a significant improvement and as a result, CCRT is used as a therapeutic option for a greater local and regional control ( 16 , 17 ).…”

“…This tool can also be used in patients who receive primary surgical treatment for SCC, as a prognostic indicator of mortality and complications ( 21 ). Higher grading of pre-existent pathologies is associated with higher chances of severe acute toxicities, postoperative surgical complications and mortality rate ( 17 , 18 ). In the present study, ACE-27 indicated a moderate decompensation (grade 2) for cardiovascular system.…”

Surgical Treatment for Advanced Oropharyngeal Cancer: A Narrative Review

“…Among all cancers, oropharyngeal squamous cell carcinoma (OPSCC) has one of the most rapidly rising incidences in high-income countries [ 3 , 4 ]. The American Joint Committee on Cancer (AJCC) differentiates OPSCC prognosis based on human papilloma virus (HPV) p16+ status [ 3 ], introducing a different staging category in the latest eighth edition of the AJCC TNM staging system [ 1 , 2 , 3 , 4 , 5 , 6 , 7 , 8 , 9 , 10 , 11 , 12 , 13 , 14 , 15 , 16 , 17 ]. P16-related OPSCC is strongly associated with a favourable overall survival (OS) and disease-free survival rate (DSS), while, conversely, p16 negative OPSCC often flags a worse prognosis [ 1 , 2 , 3 , 4 , 5 , 6 , 7 , 8 , 9 , 10 , 11 , 12 , 13 , 14 , 15 , 16 , 17 ].…”