Feasibility and safety of dose-dense modified docetaxel-cisplatin or carboplatin and 5-fluorouracil regimen (mTPF) in locally advanced or metastatic head and neck cancers: a retrospective monocentric study.
BACKGROUND
Docetaxel-cisplatin and 5-fluorouracil (TPF) chemotherapy (days 1-21) represents a standard but toxic regimen for advanced head and neck cancer (HNC). We report a retrospective monocentric study evaluating the safety and the efficacy of a dose-dense modified TPF (mTPF) regimen (days 1-14) in patients with stage III-IV HNC.


METHODS
Thirty-seven patients retrospectively included from May 2011 to May 2014 were treated with a bimonthly dose-dense mTPF regimen (40 mg/m(2) docetaxel, 40 mg/m(2) cisplatin or AUC2 carboplatin, folinic acid 400 mg/m(2) for 2 h, bolus 5-FU 400 mg/m(2) for 10 min and 5-FU 1,000 mg/m(2)/day) by continuous infusion over 46 h).


RESULTS
Chemotherapy was used as induction or palliative treatment in 12 and 25 patients, respectively, with a median age of 60 years (range 46-83). Median follow-up time was 7.4 months (2.53-16.7 months). There was no intestinal toxicity in 25 patients (68 %). Grade 3-4 hematological toxicity was noticed for 5 (13.5 %) patients. Granulocyte-colony stimulating factor was used as primary prophylaxis in 30 patients (81 %). After at least 4 delivered cycles, complete responses, partial responses and stable diseases were reported in 5 (15 %), 13 (39 %) and 5 (15 %) of the 33 evaluable patients, respectively, yielding an objective response rate of 54.5 % (39 % for palliative chemotherapy and 90 % for induction chemotherapy).


CONCLUSIONS
Dose-dense mTPF (days 1-14) is safe and seems to be as effective as TPF (days 1-21). Future prospective trials are required to confirm our results.
Department of Oncopharmacology-Pharmacogenetics, Integrated Center of Oncology (ICO) Paul Papin, 2 rue Moll, 49033, Angers Cedex 9, France. senyo@wanadoo.fr.|Radiotherapy Department, Centre Hospitalier Lyon Sud, 165 Chemin du Grand Revoyet, 69495, Pierre bénite, France. senyo@wanadoo.fr.|Radiotherapy Department, Integrated Center of Oncology (ICO) Paul Papin, 2 rue Moll, 49033, Angers Cedex 9, France. senyo@wanadoo.fr.
Séna
S
Yossi
Department of Oncopharmacology-Pharmacogenetics, Integrated Center of Oncology (ICO) Paul Papin, 2 rue Moll, 49033, Angers Cedex 9, France.
Benjamin
B
Linot
Department of Oncopharmacology-Pharmacogenetics, Integrated Center of Oncology (ICO) Paul Papin, 2 rue Moll, 49033, Angers Cedex 9, France.|Radiotherapy Department, Integrated Center of Oncology (ICO) Paul Papin, 2 rue Moll, 49033, Angers Cedex 9, France.
Guillaume
G
Peyraga
Head and Neck Surgery Department, Centre Hospitalier Universitaire, 4 Rue Larrey, 49100, Angers, France.
Renaud
R
Breheret
Head and Neck Surgery Department, Centre Hospitalier Universitaire, 4 Rue Larrey, 49100, Angers, France.
Laurent
L
Laccourreye
Department of Oncopharmacology-Pharmacogenetics, Integrated Center of Oncology (ICO) Paul Papin, 2 rue Moll, 49033, Angers Cedex 9, France.
Olivier
O
Capitain
D000368:Aged; D000369:Aged, 80 and over; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000008:administration & dosage* / Q000009:adverse effects*; D016190:Carboplatin / Q000008:administration & dosage; D002945:Cisplatin / Q000008:administration & dosage; D000077143:Docetaxel; D005240:Feasibility Studies; D005260:Female; D005472:Fluorouracil / Q000008:administration & dosage; D016179:Granulocyte Colony-Stimulating Factor / Q000627:therapeutic use; D006258:Head and Neck Neoplasms / Q000188:drug therapy*; D006801:Humans; D060828:Induction Chemotherapy; D002955:Leucovorin / Q000008:administration & dosage; D008297:Male; D008875:Middle Aged; D010166:Palliative Care; D012074:Remission Induction; D012189:Retrospective Studies; D043823:Taxoids / Q000008:administration & dosage; D016896:Treatment Outcome
D043823:Taxoids; D016179:Granulocyte Colony-Stimulating Factor; D000077143:Docetaxel; D016190:Carboplatin; D002945:Cisplatin; D002955:Leucovorin; D005472:Fluorouracil
5-fluorouracil; Cisplatin; Docetaxel; Dose-dense chemotherapy; Head and neck cancer; Quality of life