title: Is taxane/platinum/5 fluorouracil superior to taxane/platinum alone and does docetaxel trump paclitaxel in induction therapy for locally advanced oral cavity cancers?
abstract: BACKGROUND
  Cisplatin and 5 fluorouracil drug combination is inferior to the combination of taxane with these 2 drugs. However, often in clinical practice at our center giving TPF (docetaxel, cisplatin, 5 fluorouracil) is difficult in view of logistics and tolerance issues. In such a scenario, we prefer to use the 2 drugs combination of platinum and taxane. However, no study has addressed whether a 2 drugs combination, which includes taxane is inferior to the 3 drugs combination and which the taxane of choice is in the 2 drugs combination of taxane and platinum.
  
  
  METHODS
  This is a retrospective analysis of prospectively collected data of patients undergoing induction chemotherapy (IC) in oral cavity cancers from 2010 to 2012. We chose for analysis those patients who had a baseline scan done within 4 weeks of starting therapy and a follow-up scan done within 2 weeks of completion of the second cycle of IC. Response was scored in accordance with RECIST version 1.1. Chi-square analysis was done to compare response rates (RRs) between regimens.
  
  
  RESULTS
  Two hundred and forty-five patients were identified. The median age was 45 years (24-70 years), 208 (84.9%) were male patients, and 154 patients (62.9%) had primary in the Buccal mucosa. The regimens received were TPF 22 (9%), docetaxel + cisplatin 97 (39.6%), paclitaxel + cisplatin 89 (36.3%), docetaxel + carboplatin 16 (6.5%) and paclitaxel + carboplatin 21 (8.6%). The overall RRs were complete response, partial response, stable disease and progressive disease in 4 (1.6%), 56 (22.9%), 145 (59.2%) and 40 (16.3%). The 3 drugs regimen (TPF) had 50% RR as compared to 22% RR with 2 drugs regimen (P = 0.004). Docetaxel containing regimens had 30.3% RR as compared to 17.2% RR with paclitaxel containing regimens (P = 0.094).
  
  
  CONCLUSIONS
  TPF has better RR than a 2 drugs taxane-containing regimen and docetaxel leads to a better RR than paclitaxel for IC in locally advanced oral cavity cancers.
authors.forename: V
authors.initials: V
authors.lastname: Noronha
authors.forename: V
authors.initials: V
authors.lastname: Patil
authors.forename: A
authors.initials: A
authors.lastname: Joshi
authors.forename: V
authors.initials: V
authors.lastname: Muddu
authors.forename: A
authors.initials: A
authors.lastname: Bhattacharjee
authors.forename: S
authors.initials: S
authors.lastname: Juvekar
authors.forename: S
authors.initials: S
authors.lastname: Arya
authors.forename: P
authors.initials: P
authors.lastname: Chaturvedi
authors.forename: D
authors.initials: D
authors.lastname: Chaukar
authors.forename: P S
authors.initials: PS
authors.lastname: Pai
authors.forename: A K
authors.initials: AK
authors.lastname: Dcruz
authors.affiliation: Department of Medical Oncology, Surgical Oncology, Tata Memorial Centre, Mumbai, Maharashtra, India.
authors.forename: K
authors.initials: K
authors.lastname: Prabhash
mesh_terms: D000328:Adult; D000368:Aged; D000971:Antineoplastic Combined Chemotherapy Protocols; D001952:Bridged-Ring Compounds / Q000008:administration & dosage; D018572:Disease-Free Survival; D000077143:Docetaxel; D005260:Female; D005472:Fluorouracil / Q000008:administration & dosage; D006801:Humans; D060828:Induction Chemotherapy; D008297:Male; D008875:Middle Aged; D009055:Mouth / Q000187:drug effects* / Q000473:pathology; D009062:Mouth Neoplasms / Q000188:drug therapy* / Q000473:pathology; D017239:Paclitaxel / Q000008:administration & dosage; D010984:Platinum / Q000008:administration & dosage; D012074:Remission Induction; D043823:Taxoids / Q000008:administration & dosage
chemical_list: D001952:Bridged-Ring Compounds; D043823:Taxoids; D000077143:Docetaxel; C080625:taxane; D010984:Platinum; D017239:Paclitaxel; D005472:Fluorouracil