Sequential four-drug chemotherapy and intensity-modulated radiotherapy for larynx preservation in resectable advanced larynx and hypopharynx cancer: A pilot study.
OBJECTIVE
The value of additional use of cetuximab with the classical cisplatin, docetaxel and 5-fluorouracil regimen in larynx preservation remains unknown. This study was designed to resolve this issue and appraise its toxicity.


METHODS
Thirteen untreated patients with stage III-IV larynx or hypopharynx squamous cell carcinoma were recruited and received two cycles of C+TPF regimen (cetuximab plus docetaxel, cisplatinand and 5-fluorouracil), followed by one more cycle of C+TPF and intensity-modulated radiotherapy (70Gy). Primary endpoint was larynx preservation (LP) rate at 3months. Secondary endpoints were larynx function preservation (LFP) and overall survival (OS) at 12, 36 and 60months.


RESULTS
With a two-cycle induction treatment of C+TPF protocol, four (31%) and nine (69%) patients achieved complete and partial response, respectively. The top three toxicities were dermatitis (9 cases), nausea/vomiting (6 cases), and anemia (4 cases). After the full-course treatment, 12 out of 13 patients (92.3%) obtained LP at 3months. This strategy demonstrated relatively high LFP rates of 92.3%, 69.2% and 54.5% and satisfactory OS rates of 100%, 84.6% and 54.5% at 12, 36 and 60months, respectively.


CONCLUSIONS
These preliminary results suggest induction treatment with C+TPF regimens, followed by intensity-modulated radiotherapy is well-tolerated, which warrants further evaluation.
Department of Head and Neck, Sun Yat-sen University Cancer Center, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Guangzhou, Guangdong, PR China.
Xuan
X
Su
Department of Molecular Diagnostics, Sun Yat-Sen University Cancer Center, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Guangzhou, Guangdong, PR China.
Caiyun
C
He
Department of Molecular Diagnostics, Sun Yat-Sen University Cancer Center, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Guangzhou, Guangdong, PR China.
Tao
T
Tang
Department of Head and Neck, Sun Yat-sen University Cancer Center, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Guangzhou, Guangdong, PR China.
Weichao
W
Chen
Department of Head and Neck, Sun Yat-sen University Cancer Center, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Guangzhou, Guangdong, PR China.
Zhaoqu
Z
Li
Department of Radiotherapy, Sun Yat-sen University Cancer Center, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Guangzhou, Guangdong, PR China.
Yong
Y
Chen
Department of Head and Neck, Sun Yat-sen University Cancer Center, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Guangzhou, Guangdong, PR China. Electronic address: yangak@sysucc.org.cn.
Ankui
A
Yang
D000328:Adult; D000368:Aged; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000008:administration & dosage* / Q000009:adverse effects; D002294:Carcinoma, Squamous Cell / Q000401:mortality / Q000473:pathology / Q000628:therapy*; D002681:China; D002945:Cisplatin / Q000008:administration & dosage / Q000009:adverse effects; D015331:Cohort Studies; D003131:Combined Modality Therapy; D018572:Disease-Free Survival; D005260:Female; D005472:Fluorouracil / Q000008:administration & dosage / Q000009:adverse effects; D006801:Humans; D007012:Hypopharyngeal Neoplasms / Q000401:mortality / Q000473:pathology / Q000628:therapy; D007822:Laryngeal Neoplasms / Q000401:mortality / Q000473:pathology / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D059351:Organ Sparing Treatments; D010865:Pilot Projects; D011379:Prognosis; D011446:Prospective Studies; D050397:Radiotherapy, Intensity-Modulated / Q000379:methods*; D012074:Remission Induction; D018570:Risk Assessment; D016019:Survival Analysis; D043823:Taxoids / Q000008:administration & dosage / Q000009:adverse effects
D043823:Taxoids; D002945:Cisplatin; D005472:Fluorouracil