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Docetaxel, cisplatin, and fluorouracil induction chemotherapy followed by accelerated fractionation/concomitant boost radiation and concurrent cisplatin in patients with advanced squamous cell head and neck cancer: A Southwest Oncology Group phase II trial (S0216)
Author(s) -
Adelstein David J.,
Moon James,
Hanna Ehab,
Giri P. G. Shankar,
Mills Glenn M.,
Wolf Gregory T.,
Urba Susan G.
Publication year - 2010
Publication title -
head and neck
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.012
H-Index - 127
eISSN - 1097-0347
pISSN - 1043-3074
DOI - 10.1002/hed.21179
Subject(s) - medicine , docetaxel , concomitant , induction chemotherapy , taxane , cisplatin , chemoradiotherapy , chemotherapy , fluorouracil , head and neck cancer , oncology , radiation therapy , surgery , urology , cancer , breast cancer
Background In an effort to optimize nonoperative therapy in patients with locoregionally advanced head and neck squamous cell cancer, the Southwest Oncology Group conducted a phase II trial combining 3‐drug taxane‐containing induction chemotherapy with accelerated fractionation/concomitant boost radiation and concomitant single‐agent cisplatin. Methods Two induction courses using docetaxel (75 mg/m 2 on day 1), cisplatin (100 mg/m 2 on day 1), and fluorouracil (1000 mg/m 2 /day continuous intravenous infusion days 1–4) were given, with an interval of 21 days. Patients who were stable or responded to the chemotherapy received definitive accelerated fractionation/concomitant boost radiation with concurrent cisplatin (100 mg/m 2 ) on days 1 and 22 of radiation. Results There were 74 eligible and evaluable patients enrolled between March 1, 2003, and August 15, 2004; 52 (70%) had stage IV disease. At least 1 grade 3‐4 toxicity was experienced by 63 patients (85%) during induction. A total of 61 patients completed induction and began concurrent chemoradiotherapy; 50 (68%) completed all planned treatment. At least 1 grade 3‐4 toxicity was noted in 53 of the 58 patients (91%) evaluated for toxicity from concurrent chemoradiotherapy. Two patients died during induction, and 2 during chemoradiation. With a median follow‐up of 36 months (range, 14–50), the 2‐year and 3‐year overall survival estimates were 70% and 64%, with 2‐year and 3‐year progression‐free survival estimates of 66% and 61%, respectively. Conclusions Three‐drug induction chemotherapy followed by accelerated fractionation/concomitant boost radiation and concurrent cisplatin is toxic but feasible within a cooperative group. In this patient cohort with advanced head and neck squamous cell cancer, overall and progression‐free survivals were encouraging, justifying further study of this approach. © 2009 Wiley Periodicals, Inc. Head Neck, 2010