Induction chemotherapy of docetaxel and Cisplatin for the elderly patients with squamous cell carcinoma of the head and neck.
OBJECTIVE
Although concurrent chemoradiotherapy (CCRT) has been considered as a standard treatment for locally advanced squamous cell carcinoma of the head and neck (SCCHN), this treatment is associated with increased toxicities such as mucositis and dermatitis. As a result, the dose intensity can be reduced and interruptions of radiotherapy are more common for CCRT than for sequential treatment, especially for the elderly patients. This prospective study was performed to assess the efficacy and safety profiles of the induction chemotherapy of docetaxel and cisplatin for elderly patients with locally advanced SCCHN.


METHODS
Patients over 65 years of age with locally advanced SCCHN were treated with docetaxel (70 mg/m(2)) and cisplatin (75 mg/m(2)) every 21 days. The chemotherapy consisted of two cycles with a third cycle that was administered to the responding patients. Patients who did not respond to initial chemotherapy underwent radiotherapy as a definitive local treatment.


RESULTS
Fifty patients were enrolled in this study and 44 patients were assessable for response and toxicity. The overall response rate was 88%, 16 patients (36%) achieved a complete response and 23 patients (52%) achieved a partial response. After a median follow-up of 24 months (range: 9 approximately 38 months) the median disease free period and overall survival period had not yet been reached. The one year and two year survival rates were 89% and 70%, respectively. The most common grade 3/4 adverse event was neutropenia, which occurred in 33 patients (75%) and 4 patients had febrile neutropenia.


CONCLUSIONS
Combination chemotherapy of docetaxel and cisplatin is an effective regimen with an acceptable safety profile as the induction treatment for elderly patients suffering with SCCHN.
Choi
Young-Jin
YJ
Department of Internal Medicine, Pusan National University College of Medicnce, Busan, Korea.
Chung
Jooseop
J
Shin
Ho-Jin
HJ
Cho
Goon-Jae
GJ
Wang
Soo-Geun
SG
Lee
Byung-Joo
BJ
Cho
Byung-Mann
BM
Kim
Dong-Won
DW
Kim
Hak-Jin
HJ
Lee
Won Sik
WS
Joo
Young-Don
YD
Sohn
Chang-Hak
CH