title: Efficacy and safety of dose-modified docetaxel plus cisplatin-based induction chemotherapy in Asian patients with locally advanced head and neck cancer.
abstract: OBJECTIVE
  The beneficial effects of docetaxel plus cisplatin-based induction chemotherapy for patients with unresectable, advanced head and neck cancer (HNC) have been documented in Western countries. However, the efficacy of such treatment has not been confirmed in Asian patients. We aimed to determine whether incorporation of dose-modified docetaxel into a cisplatin-based induction regimen would be both effective and tolerable in our Asian population of patients.
  
  
  METHODS
  Thirty-six patients with stage III or IV HNC who had undergone cisplatin-based induction chemotherapy were included in the current analysis. Fifty-three percentage of the patients had received induction chemotherapy with bolus cisplatin and continuous 5-fluorouracil (PF group), while the remaining 47% had additionally received dose-modified docetaxel (TPF group). We assessed the relative impact of the two treatments on clinical outcomes and treatment-related toxicities.
  
  
  CONCLUSIONS
  The disease control rate was higher in the TPF group (92·9% vs. 76·5%), although the difference did not reach statistical significance (P = 0·217). Addition of docetaxel increased the median progression-free survival to 435 days, which was 2·3 times longer than that (188 days) of patients not receiving docetaxel (P = 0·019). Non-haematological toxicity profile was similar and acceptable in both treatment groups. Higher incidence of grade 3/4 neutropenia and more episodes of neutropenic fever-related hospitalization occurred in the docetaxel-treated patients, but most of them were managed uneventfully.
  
  
  CONCLUSIONS
  Addition of dose-modified docetaxel to cisplatin-based induction chemotherapy was both efficacious and generally safe. Docetaxel addition significantly prolonged progression-free survival and had an acceptable safety profile in our Asian population of patients with locoregionally advanced HNC.
authors.affiliation: Division of Hematology and Oncology, Department of Medicine, Chang Gung Memorial Hospital, Chiayi, Taiwan.
authors.forename: C-E
authors.initials: CE
authors.lastname: Huang
authors.forename: C-H
authors.initials: CH
authors.lastname: Lu
authors.forename: P-T
authors.initials: PT
authors.lastname: Chen
authors.forename: C-H H
authors.initials: CH
authors.lastname: Chan
authors.forename: W-C
authors.initials: WC
authors.lastname: Chen
authors.forename: W-H
authors.initials: WH
authors.lastname: Wang
authors.forename: J-Y
authors.initials: JY
authors.lastname: Wu
authors.forename: F-C
authors.initials: FC
authors.lastname: Kuan
authors.forename: K-D
authors.initials: KD
authors.lastname: Lee
authors.forename: C-C
authors.initials: CC
authors.lastname: Chen
mesh_terms: D000328:Adult; D000368:Aged; D000970:Antineoplastic Agents / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000008:administration & dosage* / Q000009:adverse effects / Q000627:therapeutic use; D002294:Carcinoma, Squamous Cell / Q000097:blood / Q000188:drug therapy* / Q000208:ethnology / Q000473:pathology; D002945:Cisplatin / Q000008:administration & dosage* / Q000009:adverse effects / Q000627:therapeutic use; D000077143:Docetaxel; D016903:Drug Monitoring; D005334:Fever / Q000209:etiology; D005472:Fluorouracil / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use; D006258:Head and Neck Neoplasms / Q000097:blood / Q000188:drug therapy* / Q000208:ethnology / Q000473:pathology; D006801:Humans; D015994:Incidence; D060828:Induction Chemotherapy / Q000009:adverse effects; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D009503:Neutropenia / Q000139:chemically induced / Q000453:epidemiology / Q000503:physiopathology / Q000628:therapy; D012720:Severity of Illness Index; D016019:Survival Analysis; D013624:Taiwan / Q000453:epidemiology; D043823:Taxoids / Q000008:administration & dosage* / Q000009:adverse effects / Q000627:therapeutic use
chemical_list: D000970:Antineoplastic Agents; D043823:Taxoids; D000077143:Docetaxel; D002945:Cisplatin; D005472:Fluorouracil