Abstract
Purpose
Radiotherapy (RTx) has been considered as the treatment for locally advanced squamous cell carcinoma of the head and neck (SCCHN). However, with only conventional fractionation (Cfx), response rates are relatively low. In this study, we report the results of hyperfractionation (Hfx) RTx with concurrent docetaxel, cisplatin and 5-fluorouracil (TPF) chemotherapy (CTx) in patients with locally advanced SCCHN and compare Hfx and Cfx RTx with concurrent TPF CTx.
Methods
Fifty patients with previously untreated stage III–IV SCCHN were entered into this study. Eligible patients received RTx delivered using arm 1: Hfx at 1.2 Gy/fraction, twice daily, 5 days/week to 76.8 Gy/64 fractions, and arm 2: Cfx at 2 Gy/fraction/day, 5 days/week to 70 Gy/35 fractions. Patients received 2 cycles CTx every 4 weeks. The doses were docetaxel 50 mg/m2 (day 1), cisplatin 60 mg/m2 (day 4), and 5-FU 600 mg/m2/day (days 1–5).
Results
The overall clinical response rate and the pathological CR were 100% (25/25) and 84% (21/25) in arm 1, and 100% (25/25) and 80% (20/25) in arm 2. Local–regional control was better significant in arm 1 than arm 2 (P = 0.048). There were also trend toward improved disease-free survival (P = 0.059) and overall survival (P = 0.078) in arm 1. Mucositis was significantly more frequent in arm 1 (P = 0.048).
Conclusion
There were trend toward improved local–regional control, disease-free survival and overall survival in Hfx RTx with concurrent TPF CTx, compared to Cfx RTx with concurrent TPF CTx.
Similar content being viewed by others
References
Million RR, Cassisi NJ (1994) Management of head and neck cancer. In: Cripps C (eds) A multidisciplinary approach. JB Lippincott, Philadelphia, pp 124–128
Horiot J, Le Fur R, N’Guyen T (1992) Hyperfractionation versus conventional fractionation in oropharyngeal carcinoma: final analysis of a randomized trail of the EORTC cooperative group of radiotherapy. Radiother Oncol 25:231–241
Horiot JC, Bontempts P, Begg AG (1998) New radiotherapy fractionation schemes in head and neck cancers. The EORTC trials: a benchmark. In: Kogelnik HD, Sedlymayer E (eds) Proceedings of the 6th international meeting on progress in radio-oncology VI, Monduzzi Editore, Bologna, pp 735–741
Al-Sarraf M, Pajak TF, Marcial VA (1987) Concurrent radiotherapy and chemotherapy with cisplatin in inoperable squamous cell carcinoma of the head and neck: an RTOG study. Cancer 59:259–265
Tobias JS, Smith BJ, Blackman G (1987) Concurrent daily cisplatin and radiotherapy in locally advanced squamous carcinoma of the head and neck and bronchus. Radiother Oncol 9:263–268
Browman GP, Cripps C, Hodson DI (1994) Placebo-controlled randomized trial of infusional fluorouracil during standard radiotherapy in locally advanced head and neck cancer. J Clin Oncol 12:2648–2653
Withers HR (1985) Biologic basis for altered fractionated schemes. Cancer 55:2086–2095
Withers HR (1988) Inherent acceleration of tumor dose-rate in hyperfractionated regimens (letter). Int J Radiat Oncol Biol Phys 14:400
Withers HR, Peters LJ (1980) Biological aspects of radiation therapy. In: Fletcher GH (eds): Textbook of radiotherapy, 3rd edn. Lea and Febiger, Philadelphia, p 103–115
Veterans Affairs Laryngeal Cancer Study Group (1991) Induction chemotherapy plus radiation compared with surgery plus radiation in patients with advanced laryngeal cancer. N Engl J Med 324:1685–1689
Calais G, Alfonsi M, Bardet E (1999) Randomized trial of radiation therapy versus concomitant chemotherapy and radiation therapy for advanced-stage oropharynx carcinoma. J Natl Cancer Inst 91:2081–2086
Taylor S 4th, Murthy A, Vannetzel J (1994) Randomized comparison of neoadjuvant cisplatin and fluorouracil infusion followed by radiation versus concomitant treatment in advanced head and neck cancer. J Clin Oncol 12:385–395
Janinis J, Papadakou G, Panagos G (1997) A phase II study of combined chemotherapy with docetaxel, cisplatin and 5-fluorouracil in patients with advanced squamous cell carcinoma of the head and neck and nasopharyngeal cancer. Proc Am Soc Clin Oncol 16:402a
Colevas A, Norris C, Tishler R (1999) Phase II trial of docetaxel, cisplatin, fluorouracil, and leucovorin as induction for squamous cell carcinoma of the head and neck. J Clin Oncol 17:3503–3511
Schrijvers D, Van Herpen C, Kerger J (1999) Phase I–II study with Docetaxel (D), Cisplatin(C) and 5-Fluorouracil (5-FU) in patients (pts) with locally advanced inoperable squamous cell carcinoma of the head and neck (SCCHN). Eur J Cancer 35(suppl 4):164a
Koukourakis M, Bizakis J, Skoulakis C (1999) Combined irinotecan, docetaxel and conventionally fractionated radiotherapy in locally advanced head and neck cancer. A phase I dose escalation study. Anticancer Res 19:2305–2309
Katori H, Tsukuda M, Mochimatu I (2004) Phase I trial of concurrent chemoradiotherapy with docetaxel, cisplatin and 5-fluorouracil (TPF) in patients with locally advanced squamous cell carcinoma of the head and neck (SCCHN). Br J Cancer 90:348–352
Katori H, Tsukuda M, Ishitoya J (2004) Concurrent chemoradiotherapy with docetaxel, cisplatin and 5-fluorouracil (TPF) in patients with locally advanced squamous cell carcinoma of the head and neck (SCCHN) (Abstr5560). Proc Am Soc Clin Oncol 22:14S
Katori H, Tsukuda M (2005) Comparison of induction chemotherapy with docetaxel, cisplatin, and 5-fluorouracil (TPF) followed by radiation vs concurrent chemoradiotherapy with TPF in patients with locally advanced squamous cell carcinoma of the head and neck. Clin Oncol 17:148–152
World Health Organization (1979) Handbook for reporting results of cancer treatment. In: World Health Organization (eds) WHO offset publication No. 48. World Health Organization, Geneva, pp 189–196
Kaplan EL, Meier P (1958) Nonparametric estimation from incomplete observations. J Am Stat Assoc 53:457–481
Inuyama Y, Kida A, Tsukuda M (2001) Late phase II study of S-1 in patients with advanced head and neck cancer. Jpn J Cancer Chemother 28:1381–1390
Thames HD, Withers HR, Peters LJ (1992) Changes in early and late radiation responses with altered dose fractionation: implications for dose-survival relationships. Int J Radiat Oncol Biol Phys 8:219–226
Fu KK, Pajak TF, Trotti A (2000) A Radiation Therapy Oncology Group (RTOG) phase III randomized study to compare hyperfractionation and two variants of accelerated fractionation to standard fractionation radiotherapy for head and neck squamous cell carcinomas: first report of RTOG 9003. Int J Radiat Oncol Biol Phys 48:7–16
Jeremic B, Shibamoto Y, Milicic B (2000) Hyperfractionated radiation therapy with or without concurrent low-dose daily cisplatin in locally advanced squamous cell carcinoma of the head and neck: a prospective randomized trial. J Clin Oncol 18:1458–64
Brizel DM, Albers ME, Fisher SR (1998) Hyperfractionated irradiation with or without concurrent chemotherapy for locally advanced head and neck cancer. N Engl J Med 338:1798–804
Forastiere A, Neuberg D, Taylor S (1993) Phase II evaluation of taxol in advanced head and neck cancer: An Eastern Cooperative Oncology Group trial. Monogor Natl Cancer Inst 15:181–184
Catimel G, Verwij J, Hanauska A (1994) Docetaxel (taxotere): an active drug for treatment of the treatment of the head and neck. Ann Oncol 5:553–557
Dreyfuss A, Clark J, Norris C (1996) Docetaxel: an active drug for squamous cell carcinoma of head and neck. J Clin Oncol. 14:1672–1678
Mauer A, Masters G, Haraf D (1998) Phase I study of docetaxel with concomitant thoracic radiation therapy. J Clin Oncol 16:159–164
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Katori, H., Tsukuda, M. & Watai, K. Comparison of hyperfractionation and conventional fractionation radiotherapy with concurrent docetaxel, cisplatin and 5-fluorouracil (TPF) chemotherapy in patients with locally advanced squamous cell carcinoma of the head and neck (SCCHN). Cancer Chemother Pharmacol 60, 399–406 (2007). https://doi.org/10.1007/s00280-006-0370-y
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s00280-006-0370-y