Mari Takenaka, Akihito Arai*, Koichi Yoshizawa, Kanako Yoshimura, Junichi Mitsuda, Sumiyo Saburi, Takahiro Tsujikawa, Yoichiro Sugiyama and Shigeru Hirano
Department of Otolaryngology, Head and Neck Surgery, Kyoto Prefectural University of Medicine, JapanFulltext PDF
Background/Objective: Combination of Docetaxel, Cisplatin, 5-FU (TPF) is regarded as the current standard regimen as induction chemotherapy for locally advanced Head and Neck Squamous Cell Carcinoma (HNSCC), but the problem is severe toxicity which occasionally causes treatment-related mortality. The current study examined feasibility of combination with Paclitaxel, Carboplatin and Cetuximab (PCE) as comparable regimen with less toxicity. Materials and Methods: The efficacy and the adverse events of 2 cycles of PCE regimen were retrospectively examined for 40 cases with stage III/IV HNSCC using RECIST and CTCAE. Results: Thirty-five cases (87.5%) completed 2 cycles of PCE therapy. Overall Response Rate (ORR) was 65%: 50% in oral and sinonasal cancers, 57% in laryngeal cancer, 87.5% in hypopharyngeal cancer, and 100% in oropharyngeal cancer. Infusion reaction and interstitial pneumonia occurred in one case for each. Neutropenia and febrile neutropenia occurred in 60% and 7.5%, respectively. Elderly were not significant factor of increased adverse events. All cases were successfully treated with definitive radiotherapy, chemoradiotherapy, or surgery following PCE. Two year overall and disease specific survival rates were 80% and 82.6%, respectively. Conclusion: Induction therapy with PCE showed comparable effects to TPF with less toxicity. PCE is available in outpatient set-up even for elderly. Although the survival data is immature and the number of subjects is still small, it is suggested that PCE should be useful as induction chemotherapy for advanced HNSCC.
Induction chemotherapy; Paclitaxel; Carboplatin; Cetuximab; Head and neck cancer; Efficacy
Takenaka M, Arai A, Yoshizawa K, Yoshimura K, Mitsuda J, Saburi S, et al. Feasibility of Combination of Paclitaxel, Carboplatin, and Cetuximab as Induction Chemotherapy for Advanced Head and Neck Squamous Cell Carcinoma. Clin Oncol. 2019;4:1657.