title: Feasibility of concurrent chemoradiotherapy with high-dose cisplatin after induction TPF chemotherapy in head and neck cancer: a critical review of the literature and the experience of the European Institute of Oncology.
abstract: Many concerns are related to the idea that the acute toxicity of induction chemotherapy (IC) performed with TPF (docetaxel, cisplatin, 5-fluorouracil) could reduce the ability to deliver the subsequent standard concurrent chemoradiotherapy (CRT) in head and neck cancer patients. We performed a critical review of the literature on the toxicity profile of the standard CRT administered after the IC with TPF. A total of 13 papers (including 950 patients) were selected. Results showed that most patients were treated with an adequate radiation total dose although a significant proportion of them (from 15 to 30%) completed the planned treatment with a delay of more than 5 days. A minority of patients were able to be treated with three cycles of concurrent cisplatin, but only few papers reported how many of patients reached the cumulative total dose of almost 200 mg/m2cisplatin. The rate of deaths due to treatment-related toxicity varied from 0 to 9% (median and mean 2%). Two prospective trials stopped patient enrollment due to acute treatment-related toxicity and because a low number of patients were able to undergo the planned full schedule of cisplatin during the CRT, respectively. Retrospective analysis of 45 patients treated at our institute showed that this schedule was feasible with manageable side effects. In conclusion, the literature data did not provide homogeneous information on the feasibility of the standard CRT after induction TPF. A more uniform data collection of treatment-related toxicity will be helpful in better selecting the patients who might adequately tolerate this multimodality strategy.
authors.affiliation: Department of Radiotherapy, European Institute of Oncology, Via Ripamonti, 435, 20141, Milan, Italy. daniela.alterio@ieo.it.
authors.forename: D
authors.identifier: http://orcid.org/0000-0003-1086-0736
authors.initials: D
authors.lastname: Alterio
authors.affiliation: Medical Oncology Division of Urogenital and Head and Neck Tumours, European Institute of Oncology, Milan, Italy.
authors.forename: M
authors.initials: M
authors.lastname: Cossu Rocca
authors.affiliation: Library of European Institute of Oncology, Milan, Italy.
authors.forename: W
authors.initials: W
authors.lastname: Russell-Edu
authors.affiliation: Department of Oncology and Hemato-oncology, University of Milan, Milan, Italy.
authors.forename: S
authors.initials: S
authors.lastname: Dicuonzo
authors.affiliation: Department of Oncology and Hemato-oncology, University of Milan, Milan, Italy.
authors.forename: G
authors.initials: G
authors.lastname: Fanetti
authors.affiliation: Department of Radiotherapy, European Institute of Oncology, Via Ripamonti, 435, 20141, Milan, Italy.
authors.forename: G
authors.initials: G
authors.lastname: Marvaso
authors.affiliation: Particle Therapy Cancer Research Institute, CNAO Foundation, Pavia, Italy.|University of Pavia, Pavia, Italy.
authors.forename: L
authors.initials: L
authors.lastname: Preda
authors.affiliation: Department of Otolaryngology - Head and Neck Surgery, European Institute of Oncology, Milan, Italy.
authors.forename: S
authors.initials: S
authors.lastname: Zorzi
authors.affiliation: Medical Oncology Division of Urogenital and Head and Neck Tumours, European Institute of Oncology, Milan, Italy.
authors.forename: E
authors.initials: E
authors.lastname: Verri
authors.affiliation: Medical Oncology Division of Urogenital and Head and Neck Tumours, European Institute of Oncology, Milan, Italy.
authors.forename: F
authors.initials: F
authors.lastname: Nole'
authors.affiliation: Department of Radiotherapy, European Institute of Oncology, Via Ripamonti, 435, 20141, Milan, Italy.|Department of Oncology and Hemato-oncology, University of Milan, Milan, Italy.
authors.forename: B A
authors.initials: BA
authors.lastname: Jereczek-Fossa
mesh_terms: D000971:Antineoplastic Combined Chemotherapy Protocols / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D059248:Chemoradiotherapy; D002945:Cisplatin / Q000008:administration & dosage; D000077143:Docetaxel; D005240:Feasibility Studies; D005472:Fluorouracil / Q000008:administration & dosage; D006258:Head and Neck Neoplasms / Q000188:drug therapy* / Q000532:radiotherapy*; D006801:Humans; D012189:Retrospective Studies; D043823:Taxoids / Q000008:administration & dosage
chemical_list: D043823:Taxoids; D000077143:Docetaxel; D002945:Cisplatin; D005472:Fluorouracil
keywords: Acute toxicity; Chemoradiotherapy; Head and neck cancer; Induction chemotherapy