Neoadjuvant modified TPF (docetaxel, cisplatin, fluorouracil) for patients unfit to standard TPF in locally advanced head and neck squamous cell carcinoma: a study of 48 patients.
TPF (docetaxel, cisplatin, fluorouracil) is the standard chemotherapy used for induction in locally advanced head and neck squamous cell carcinoma (LAHNSCC). Its toxicity limits it to younger patients with good functional status and without significant comorbidity. Since modified TPF (mTPF) demonstrated higher tolerability with similar efficacy in gastric cancer, we tested this scheme on frail patients.From July 2010 to July 2014, the files of the 48 patients treated for LAHNSCC with mTPF in three French institutions were retrospectively collected.mTPF was chosen because of age>70 years, or severe denutrition, or PS>1, or severe comorbidities or after severe toxicity of standard TPF. During the first 4 cycles, 2 patients died, 14 secondary hospitalizations were required and 10 patients stopped treatment due to no lethal toxicity. Two patients died during radiotherapy.The response rate was 83% (19% complete response). With a median follow-up of 15.2 months, 4 patients died during treatment, 8 died of non-head and neck cancer related disorders, 18 progressed (17 deaths) and 18 were free of disease. The median overall survival was 18.5 months (95% IC: 16.9-30.0).mTPF is effective in terms of response rate compared with the standard TPF and could become a new option in induction for frail patients with LAHNSCC.
Department of Medicine, Léon Bérard Center, University of Lyon, Lyon, France.
Jérôme
J
Fayette
Department of Medicine, Léon Bérard Center, University of Lyon, Lyon, France.
Clara
C
Fontaine-Delaruelle
Department of Surgery, Croix-Rousse Hospital, University of Lyon, Lyon, France.
Alexis
A
Ambrun
Department of Surgery, Edouard Herriot Hospital, University of Lyon, Lyon, France.
Clémentine
C
Daveau
Department of Surgery, Croix-Rousse Hospital, University of Lyon, Lyon, France.
Marc
M
Poupart
Department of Surgery, Edouard Herriot Hospital, University of Lyon, Lyon, France.
Antoine
A
Ramade
Department of Surgery, Léon Bérard Center, University of Lyon, Lyon, France.
Philippe
P
Zrounba
Department of Medicine, Léon Bérard Center, University of Lyon, Lyon, France.
Eve-Marie
EM
Neidhardt
Department of Medical Oncology, Institut du Cancer des Hospices Civils de Lyon, Centre Hospitalier Lyon-Sud, University of Lyon, Pierre-Bénite, France.|CNRS-UMR 5558, Biometry and Evolutive Biology Laboratory, Health and Biostatistics Team, Villeurbanne, France.
Julien
J
Péron
Department of Surgery, Lyon Sud Hospital Center, University of Lyon, Pierre-Bénite, France.
Alpha
A
Diallo
Department of Surgery, Edouard Herriot Hospital, University of Lyon, Lyon, France.|Department of Surgery, Lyon Sud Hospital Center, University of Lyon, Pierre-Bénite, France.
Philippe
P
Céruse
D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D000970:Antineoplastic Agents / Q000009:adverse effects / Q000627:therapeutic use*; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000009:adverse effects / Q000627:therapeutic use*; D002294:Carcinoma, Squamous Cell / Q000188:drug therapy* / Q000401:mortality / Q000473:pathology / Q000532:radiotherapy; D002945:Cisplatin / Q000009:adverse effects / Q000627:therapeutic use; D018572:Disease-Free Survival; D000077143:Docetaxel; D005260:Female; D005472:Fluorouracil / Q000009:adverse effects / Q000627:therapeutic use; D005500:Follow-Up Studies; D016330:Frail Elderly; D006258:Head and Neck Neoplasms / Q000188:drug therapy* / Q000401:mortality / Q000532:radiotherapy; D006801:Humans; D008297:Male; D008875:Middle Aged; D020360:Neoadjuvant Therapy / Q000009:adverse effects / Q000379:methods*; D009367:Neoplasm Staging; D012189:Retrospective Studies; D043823:Taxoids / Q000009:adverse effects / Q000627:therapeutic use
D000970:Antineoplastic Agents; D043823:Taxoids; D000077143:Docetaxel; D002945:Cisplatin; D005472:Fluorouracil
TPF; cisplatin; frail patients; head and neck cancer; induction