Standard or split TPF induction chemotherapy followed by bioradiation: ICRAT randomized phase II study.

Meta-analysis of chemotherapy in head and neck cancer (MACH-NC): An update on 107 randomized trials and 19,805 patients, on behalf of MACH-NC Group

“…To decrease TPF toxicity without changing efficacy, modified schedule of TPF has been proposed. But, data from randomized trial are currently limited and results mixed [133,134]. Better selection tools to identify patients who will benefit from TPF induction remain needed.…”

A Randomized Study Analyzing Clinical and Dosimetric Outcome in Locally Advanced Head-and-Neck Cancer Treated With Conformal Chemoradiation With or Without Induction Chemotherapy

“…In this study, we have modified the conventional induction treatment plan using a 1-day slow infusion of 5FU as per institutional logistics. There have been attempts to use a modified TPF regimen to decrease its toxicity without altering the efficacy, but the available data are scarce and mixed [16,17]. Accelerated repopulation is also a noted radiobiological concern in head-and-neck squamous cell cancer, to address this issue, we started CTRT 2 weeks after completion of induction TPF, while several trials used a 3-5-week gap.…”

Induction chemotherapy followed by radiochemotherapy for locally advanced head and neck cancer as an individual treatment approach—Feasibility, safety and retrospective survival analysis in twenty‐three patients

“…Due to a synchronously running parallel study, we also applied another protocol according to Stromberger et al . This trial compared two TPF ICT regimens followed by bioradiation vs. CRT in terms of efficacy, toxicity and survival.…”

“…5 In contrast to that particular trial, the application of four cycles was often difficult to implement in our clinical routine. Consequently, we administered three cycles of ICT Due to a synchronously running parallel study, we also applied another protocol according to Stromberger et al 6 This trial compared two TPF ICT regimens followed by bioradiation vs. CRT in terms of efficacy, toxicity and survival. Reported haematological toxicities were more pronounced in that study than in our cohort.…”

“…More recently Yung et al have described an endoscopic technique (Ipswich procedure) where an initial endoscopic DCR is converted into a CDCR by forming a fistula from the medial conjunctival fornix, which is lined with a superiorly based septal flap. 6 Rather than healing by secondary intention as described by…”