title: [Observance and results of concurrent chemoradiotherapy after induction chemotherapy by docetaxel, cisplatin and 5-fluoro-uracil for locally advanced head and neck cancers].
abstract: OBJECTIVE
  Retrospectively evaluate the safety, feasibility and efficacy of concomitant chemoradiotherapy after induction chemotherapy by docetaxel, cisplatin and 5-fluoro-uracil for locally advanced head and neck cancers.
  
  
  METHODS
  Patients' data from three radiotherapy centres in South of France, with locally advanced head and neck cancers, and treated between December 2007 and July 2013 by concomitant chemoradiotherapy, after induction chemotherapy by docetaxel, cisplatin and 5-fluoro-uracil, were analysed. Adverse effects were graduated according to CTCAE v3.0 criteria. Overall survival and disease-free survival were calculated according to Kaplan-Meier method.
  
  
  RESULTS
  One hundred and sixty-eight patients, mostly oropharynx (38%) T4 (46%) N2 (54%) tumors, received, after induction chemotherapy by docetaxel, cisplatin and 5-fluoro-uracil, a concomitant chemoradiotherapy with platin or cetuximab, which delivered 66 to 70Gy. Grade 3-4 adverse effects were less frequent in the group of patients who received cisplatin (with or withour 5-fluoro-uracil) at 100mg/m(2) each 21 days compared to cetuximab (radiomucositis: 32.5% vs 61%, P=0.018; radioepithelitis: 13% vs 61 %, P<0.0001). Chemopotentiation was incomplete for 21% of patients without impacting survival. Two years overall survival and disease-free survival were respectively of 81% and 64%. Lymph nodes status and WHO status significantly influenced these survivals (overall survival 84% if N<3 vs 56% if N3, P=0.017 and 85 % if WHO status ≤ 1 vs 50% if WHO status>1, P=0.006; disease-free survival 66% if N<3 vs 47% if N3, P=0.046).
  
  
  CONCLUSIONS
  The association of induction chemotherapy by docetaxel, cisplatin and 5-fluoro-uracil and concomitant chemoradiotherapy shows satisfying results with an acceptable toxicity. The terms of the chemopotentiation and its superiority to a single concomitant chemoradiotherapy treatment still remain to be clarified.
authors.affiliation: Service de radiothérapie, centre hospitalier universitaire de la Timone, 264, rue Saint-Pierre, 13005 Marseille, France. Electronic address: benoit.calderon@ap-hm.fr.
authors.forename: B
authors.initials: B
authors.lastname: Calderon
authors.affiliation: Centre de radiothérapie Saint-Louis, Croix-Rouge française, quartier Sainte-Musse, rue André-Blondel, 83100 Toulon, France.
authors.forename: C
authors.initials: C
authors.lastname: Guerder
authors.affiliation: Service de radiothérapie, institut Paoli-Calmettes, 232, boulevard Sainte-Marguerite, 13273 Marseille cedex 9, France.
authors.forename: M
authors.initials: M
authors.lastname: Resbeut
authors.affiliation: Service de chirurgie ORL, centre hospitalier universitaire de la Timone, 264, rue Saint-Pierre, 13005 Marseille, France.
authors.forename: N
authors.initials: N
authors.lastname: Fakhry
authors.affiliation: Service d'oncologie médicale, centre hospitalier universitaire de la Timone, 264, rue Saint-Pierre, 13005 Marseille, France.
authors.forename: C
authors.initials: C
authors.lastname: Dupuis
authors.affiliation: Service de radiothérapie, centre hospitalier universitaire de la Timone, 264, rue Saint-Pierre, 13005 Marseille, France; Faculté de médecine de Marseille, 27, boulevard Jean-Moulin, 13005 Marseille, France.
authors.forename: D
authors.initials: D
authors.lastname: Cowen
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use; D000068818:Cetuximab / Q000627:therapeutic use; D059248:Chemoradiotherapy; D002945:Cisplatin / Q000008:administration & dosage; D018572:Disease-Free Survival; D000077143:Docetaxel; D005260:Female; D005472:Fluorouracil / Q000008:administration & dosage; D005602:France / Q000453:epidemiology; D006258:Head and Neck Neoplasms / Q000401:mortality* / Q000473:pathology / Q000628:therapy*; D006801:Humans; D008207:Lymphatic Metastasis; D008297:Male; D008875:Middle Aged; D011879:Radiotherapy Dosage; D012189:Retrospective Studies; D043823:Taxoids / Q000008:administration & dosage; D055815:Young Adult
chemical_list: D043823:Taxoids; D000077143:Docetaxel; D000068818:Cetuximab; D002945:Cisplatin; D005472:Fluorouracil
keywords: Cancers de la tête et du cou; Chimiothérapie d’induction; Concomitant chemoradiotherapy; Head and neck cancers; Induction chemotherapy; Radiochimiothérapie concomitante