Oncotarget

Clinical Research Papers:

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

Jérôme Fayette _, Clara Fontaine-Delaruelle, Alexis Ambrun, Clémentine Daveau, Marc Poupart, Antoine Ramade, Philippe Zrounba, Eve-Marie Neidhardt, Julien Péron, Alpha Diallo and Philippe Céruse

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Oncotarget. 2016; 7:37297-37304. https://doi.org/10.18632/oncotarget.8934

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Abstract

Jérôme Fayette1, Clara Fontaine-Delaruelle1, Alexis Ambrun2, Clémentine Daveau3, Marc Poupart2, Antoine Ramade3, Philippe Zrounba4, Eve-Marie Neidhardt1, Julien Péron5,6, Alpha Diallo7 and Philippe Céruse3,7

1 Department of Medicine, Léon Bérard Center, University of Lyon, Lyon, France

2 Department of Surgery, Croix-Rousse Hospital, University of Lyon, Lyon, France

3 Department of Surgery, Edouard Herriot Hospital, University of Lyon, Lyon, France

4 Department of Surgery, Léon Bérard Center, University of Lyon, Lyon, France

5 Department of Medical Oncology, Institut du Cancer des Hospices Civils de Lyon, Centre Hospitalier Lyon-Sud, University of Lyon, Pierre-Bénite, France

6 CNRS-UMR 5558, Biometry and Evolutive Biology Laboratory, Health and Biostatistics Team, Villeurbanne, France

7 Department of Surgery, Lyon Sud Hospital Center, University of Lyon, Pierre-Bénite, France

Correspondence to:

Jérôme Fayette, email:

Keywords: TPF, head and neck cancer, induction, cisplatin, frail patients

Received: January 26, 2016 Accepted: April 16, 2016 Published: April 22, 2016

Abstract

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.


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