title: Efficacy and feasibility of docetaxel, cisplatin, and 5-fluorouracil induction chemotherapy for locally advanced head and neck squamous cell carcinoma classified as clinical nodal stage N2c, N3, or N2b with supraclavicular lymph node metastases.
abstract: BACKGROUND
  We evaluated the efficacy and feasibility of docetaxel, cisplatin, and 5-fluorouracil (TPF) induction chemotherapy followed by concurrent chemoradiotherapy (CRT) for locally advanced head and neck squamous cell carcinoma (HNSCC) with a high risk of distant metastases compared with CRT alone.
  
  
  METHODS
  We retrospectively analyzed 29 HNSCC patients with clinical nodal stage N2c, N3, or N2b disease and supraclavicular lymph node metastases receiving CRT alone (CRT group; n = 16) or TPF induction chemotherapy followed by CRT (TPF group; n = 13) between April 2008 and May 2012.
  
  
  RESULTS
  The median follow-up periods were 14.5 (range 5.0-65.0) and 25.0 (range 14.0-32.0) months for CRT and TPF groups, respectively. A greater proportion of patient characteristics in the CRT group had advanced T and N stages. The overall response rate to induction TPF was 50.0%; grade 3-4 toxicities included neutropenia, febrile neutropenia, anorexia, and hyponatremia. Complete response rates after CRT completion were 55.5% in the TPF and 42.9% in the CRT group; median overall survival was not reached in the TPF group and was 14.0 months in the CRT group (p = 0.037). Multivariate analysis revealed that induction TPF and T stage were independent prognostic factors [hazard ratio (HR) = 0.196; 95% confidence interval (CI) 0.043-0.898; p = 0.036, HR = 9.966; 95% CI 2.270-43.75; p = 0.002, respectively).
  
  
  CONCLUSIONS
  TPF followed by CRT is tolerated and may be an option for the treatment of locally advanced stage N2c, N3, or N2b HNSCC.
authors.affiliation: Division of Gastrointestinal Oncology, Shizuoka Cancer Center, 1007 Shimonagakubo Nagaizumi Sunto-gun, Shizuoka, 411-8777, Japan.
authors.forename: Naoki
authors.initials: N
authors.lastname: Izawa
authors.forename: Yusuke
authors.initials: Y
authors.lastname: Onozawa
authors.forename: Tomomi
authors.initials: T
authors.lastname: Hikosaka
authors.forename: Satoshi
authors.initials: S
authors.lastname: Hamauchi
authors.forename: Takahiro
authors.initials: T
authors.lastname: Tsushima
authors.forename: Akiko
authors.initials: A
authors.lastname: Todaka
authors.forename: Nozomu
authors.initials: N
authors.lastname: Machida
authors.forename: Yutaka
authors.initials: Y
authors.lastname: Haraguchi
authors.forename: Hirofumi
authors.initials: H
authors.lastname: Ogawa
authors.forename: Tetsuo
authors.initials: T
authors.lastname: Nishimura
authors.forename: Masahiro
authors.initials: M
authors.lastname: Nakagawa
authors.forename: Tomohito
authors.initials: T
authors.lastname: Fuke
authors.forename: Yoshiyuki
authors.initials: Y
authors.lastname: Iida
authors.forename: Tomoyuki
authors.initials: T
authors.lastname: Kamijo
authors.forename: Tetsuro
authors.initials: T
authors.lastname: Onitsuka
authors.forename: Narikazu
authors.initials: N
authors.lastname: Boku
authors.forename: Hirofumi
authors.initials: H
authors.lastname: Yasui
authors.forename: Tomoya
authors.initials: T
authors.lastname: Yokota
mesh_terms: D000368:Aged; D000971:Antineoplastic Combined Chemotherapy Protocols; D002294:Carcinoma, Squamous Cell / Q000188:drug therapy* / Q000473:pathology; D059248:Chemoradiotherapy; D002945:Cisplatin / Q000008:administration & dosage; D000077143:Docetaxel; D005240:Feasibility Studies; D005260:Female; D005472:Fluorouracil / Q000008:administration & dosage; D006258:Head and Neck Neoplasms / Q000188:drug therapy* / Q000473:pathology; D006801:Humans; D060828:Induction Chemotherapy; D008198:Lymph Nodes / Q000473:pathology; D008207:Lymphatic Metastasis; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D012189:Retrospective Studies; D043823:Taxoids / Q000008:administration & dosage; D016896:Treatment Outcome
chemical_list: D043823:Taxoids; D000077143:Docetaxel; D002945:Cisplatin; D005472:Fluorouracil