title: Multimodality treatment including postoperative radiation and concurrent chemotherapy with weekly docetaxel is feasible and effective in patients with oral and oropharyngeal cancer.
abstract: BACKGROUND
  To examine the feasibility and efficacy of weekly docetaxel with concurrent radiation as postoperative treatment in a multimodality approach to oral and oropharyngeal cancer.
  
  
  METHODS
  94 patients (Table 1) with primary resectable squamous cell carcinoma of the oral cavity and oropharynx (UICC stage I 14%, II 15%, III 18%, IV 53%; Table 2) were treated with a multimodality therapy program consisting of neoadjuvant intra-arterial high-dose chemotherapy (cisplatin 150 mg/m(2) with parallel systemic sodium thiosulfate 9 g/m(2) for neutralization), followed by surgery of the primary and neck, and postoperative concurrent radiation and chemotherapy with weekly docetaxel (20-30 mg/m(2); Table 3). Chronic toxicities were followed over a period of 5 years.
  
  
  RESULTS
  At a median follow-up of 4 years, the 5-year survival rate for all 94 patients was 80%, and disease-free survival was 73% (Figures 1 and 2). Among patients with advanced disease (stage III and IV), survival was 83 and 59%, respectively (Figure 4). Grade 3 and 4 mucositis was the main acute toxicity necessitating supportive care. Long-term toxicity appears to be moderate (Table 4). The maximum tolerated dose of weekly docetaxel was 25 mg/m(2).
  
  
  CONCLUSIONS
  Concurrent radiation and chemotherapy with weekly docetaxel is a feasible postoperative treatment in a multimodality approach to oral and oropharyngeal cancer, resulting in high overall and disease-free survival. This approach warrants further evaluation in prospective randomized trials.
authors.affiliation: Department of Maxillofacial Plastic Surgery, Johann Wolfgang Goethe University, Frankfurt am Main Medical School, Frankfurt am Main, Germany. A.Kovacs@em.uni-frankfurt.de
authors.forename: Adorján F
authors.initials: AF
authors.lastname: Kovács
authors.forename: Stephan
authors.initials: S
authors.lastname: Mose
authors.forename: Heinz D
authors.initials: HD
authors.lastname: Böttcher
authors.forename: Klaus
authors.initials: K
authors.lastname: Bitter
mesh_terms: D000328:Adult; D000368:Aged; D000970:Antineoplastic Agents / Q000008:administration & dosage / Q000627:therapeutic use; D000972:Antineoplastic Agents, Phytogenic / Q000008:administration & dosage*; D002294:Carcinoma, Squamous Cell / Q000188:drug therapy / Q000401:mortality / Q000473:pathology / Q000532:radiotherapy / Q000601:surgery / Q000628:therapy*; D002945:Cisplatin / Q000008:administration & dosage / Q000627:therapeutic use; D003131:Combined Modality Therapy; D018572:Disease-Free Survival; D000077143:Docetaxel; D005240:Feasibility Studies; D005260:Female; D005500:Follow-Up Studies; D006257:Head / Q000473:pathology; D006258:Head and Neck Neoplasms / Q000188:drug therapy / Q000401:mortality / Q000473:pathology / Q000532:radiotherapy / Q000601:surgery / Q000628:therapy*; D006801:Humans; D007262:Infusions, Intravenous; D007269:Injections, Intra-Arterial; D008297:Male; D008875:Middle Aged; D009333:Neck / Q000473:pathology; D037981:Neck Dissection; D020360:Neoadjuvant Therapy; D009367:Neoplasm Staging; D011182:Postoperative Care; D011879:Radiotherapy Dosage; D018714:Radiotherapy, Adjuvant; D016019:Survival Analysis; D043823:Taxoids / Q000008:administration & dosage*; D013885:Thiosulfates / Q000008:administration & dosage / Q000627:therapeutic use; D013997:Time Factors; D016896:Treatment Outcome
chemical_list: D000970:Antineoplastic Agents; D000972:Antineoplastic Agents, Phytogenic; D043823:Taxoids; D013885:Thiosulfates; D000077143:Docetaxel; C017717:sodium thiosulfate; D002945:Cisplatin