HNO

, Volume 58, Issue 12, pp 1156–1162

Aktueller Stellenwert der Induktionschemotherapie

ASCO-Kongress 2010
Leitthema
  • 107 Downloads

Zusammenfassung

Ziel der primär systemischen Induktionschemotherapie ist neben dem Organerhalt das Downstaging des Tumors zur Verbesserung der Resektabilität und Reduzierung des Operationsrisikos. Nicht nur eine Verlängerung der Überlebenszeit, sondern auch der Anspruch auf gleichzeitige Verbesserung der Lebensqualität in der Behandlung von Patienten mit Karzinomen der Kopf-Hals-Region (HNSCC) haben eine Weiterentwicklung der bisherigen Therapieverfahren erforderlich gemacht. Enttäuschende Ergebnisse verhinderten den Durchbruch der PF-Therapie (Cisplatin und 5-Fluorouracil, 5-FU). Neuere Ansätze mit Docetaxel, Cisplatin und 5-FU (TPF) als Dreifachkombination sowie die zusätzliche Erweiterung um biologische Targets in Studiendesign lassen Hoffnung schöpfen. So hat sich die Kombination aus TPF als Standardregime der Induktionschemotherapie etablieren können.

Schlüsselwörter

Karzinom Kopf-Hals-Region Induktionschemotherapie Biologische Targets Taxane 

The current value of induction chemotherapy

ASCO congress 2010

Abstract

The aim of systemic induction chemotherapy is organ preservation and tumor downstaging to improve resectability and reduce surgical risk. Not only the prolongation of overall survival but also the entitlement to a better quality of life during the treatment of patients with head and neck squamous cell cancer (HNSCC) have made changes to current treatment regimes necessary. Disappointing results prevented the breakthrough of PF therapy (cisplatin and 5-fluorouracil, 5-FU). New approaches using docetaxel, cisplatin and 5-FU (TPF) as a triple combination as well as the additional extension of novel biological targets within study designs are cause for fresh hope. Thus, the TPF combination has been established as the standard induction chemotherapy regime.

Keywords

Carcinoma Head and neck Chemotherapy, induction Biological targets Taxanes 

Literatur

  1. 1.
    Statistisches Bundesamt (2009) Statistisches Jahrbuch für die Bundesrepublik Deutschland. Statistisches Bundesamt, WiesbadenGoogle Scholar
  2. 2.
    Wittes R et al (1979) cis-Dichlorodiammineplatinum(II)-based chemotherapy as initial treatment of advanced head and neck cancer. Cancer Treat Rep 63(9–10):1533–1538Google Scholar
  3. 3.
    Head and Neck Contracts Program (1987) Adjuvant chemotherapy for advanced head and neck squamous carcinoma. Final report of the Head and Neck Contracts Program. Cancer 60(3):301–311CrossRefGoogle Scholar
  4. 4.
    Weaver A et al (1984) Superior clinical response and survival rates with initial bolus of cisplatin and 120 hour infusion of 5-fluorouracil before definitive therapy for locally advanced head and neck cancer. Am J Surg 148(4):525–529CrossRefPubMedGoogle Scholar
  5. 5.
    Weaver A et al (1982) Cis-platinum and 5-fluorouracil as induction therapy for advanced head and neck cancer. Am J Surg 144(4):445–448CrossRefPubMedGoogle Scholar
  6. 6.
    The Department of 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(24):1685–1690CrossRefGoogle Scholar
  7. 7.
    Lefebvre JL et al (1996) Larynx preservation in pyriform sinus cancer: preliminary results of a European Organization for Research and Treatment of Cancer phase III trial. EORTC Head and Neck Cancer Cooperative Group. J Natl Cancer Inst 88(13):890–899CrossRefPubMedGoogle Scholar
  8. 8.
    Forastiere AA et al (2003) Concurrent chemotherapy and radiotherapy for organ preservation in advanced laryngeal cancer. N Engl J Med 349(22):2091–2098CrossRefPubMedGoogle Scholar
  9. 9.
    Forastiere AA et al (1998) Final report of a phase II evaluation of paclitaxel in patients with advanced squamous cell carcinoma of the head and neck: an Eastern Cooperative Oncology Group trial (PA390). Cancer 82(11):2270–2274CrossRefPubMedGoogle Scholar
  10. 10.
    Dreyfuss AI et al (1996) Docetaxel: an active drug for squamous cell carcinoma of the head and neck. J Clin Oncol 14(5):1672–1678PubMedGoogle Scholar
  11. 11.
    Posner MR et al (2001) Multicenter phase I-II trial of docetaxel, cisplatin, and fluorouracil induction chemotherapy for patients with locally advanced squamous cell cancer of the head and neck. J Clin Oncol 19(4):1096–1104PubMedGoogle Scholar
  12. 12.
    Schrijvers D et al (2004) Docetaxel, cisplatin and 5-fluorouracil in patients with locally advanced unresectable head and neck cancer: a phase I-II feasibility study. Ann Oncol 15(4):638–645CrossRefPubMedGoogle Scholar
  13. 13.
    Vermorken JB et al (2007) Cisplatin, fluorouracil, and docetaxel in unresectable head and neck cancer. N Engl J Med 357(17):1695–1704CrossRefPubMedGoogle Scholar
  14. 14.
    Hitt R et al (2005) Phase III study comparing cisplatin plus fluorouracil to paclitaxel, cisplatin, and fluorouracil induction chemotherapy followed by chemoradiotherapy in locally advanced head and neck cancer. J Clin Oncol 23(34):8636–8645CrossRefPubMedGoogle Scholar
  15. 15.
    Posner MR et al (2007) Cisplatin and fluorouracil alone or with docetaxel in head and neck cancer. N Engl J Med 357(17):1705–1715CrossRefPubMedGoogle Scholar
  16. 16.
    Lorch JH et al (2010) Long-term results from TAX324: A phase III trial of sequential therapy comparing TPF to PF in locally advanced (LA) squamous cell cancer of the head and neck (HNC). J Clin Oncol (Meeting Abstracts) 28(Suppl 15):5512Google Scholar
  17. 17.
    Parthan A et al (2009) Cost utility of docetaxel as induction chemotherapy followed by chemoradiation in locally advanced squamous cell carcinoma of the head and neck. Head Neck 31(10):1255–1262CrossRefPubMedGoogle Scholar
  18. 18.
    McGhie J, Winquist E (2010) Network meta-analysis (MA) of taxane-based neoadjuvant chemotherapy (NCT) for locally advanced squamous cell carcinoma of the head and neck (LA SCCHN). J Clin Oncol (Meeting Abstracts) 28(Suppl 15):5568Google Scholar
  19. 19.
    Haddad RI et al (2010) The PARADIGM trial: A phase III study comparing sequential therapy (ST) to concurrent chemoradiotherapy (CRT) in locally advanced head and neck cancer (LAHNC): Preliminary toxicity report. J Clin Oncol (Meeting Abstracts) 28(Suppl 15):5563Google Scholar
  20. 20.
    Ferris RL et al (2010) Induction docetaxel, cisplatin, and cetuximab (TPE) followed by concurrent radiotherapy, cisplatin, and cetuximab and maintenance cetuximab in patients with locoregionally advanced head and neck cancer (HNC): Mature results with HPV analysis. J Clin Oncol (Meeting Abstracts) 28(Suppl 15):5515Google Scholar
  21. 21.
    Wanebo HJ et al (2010) Phase II induction cetuximab (C225), paclitaxel (P), and carboplatin (C) followed by chemoradiation with C225, P, C, and RT 68–72 Gy for stage III/IV head and neck squamous cancer: Primary site organ preservation and disease control at 2 years (ECOG, E2303). J Clin Oncol (Meeting Abstracts) 28(Suppl 15):5513Google Scholar
  22. 22.
    Numico G et al (2010) Induction chemotherapy with carboplatin and paclitaxel followed by radiotherapy and concurrent weekly carboplatin plus paclitaxel in locally advanced nasopharyngeal carcinoma in a nonendemic population. J Clin Oncol (Meeting Abstracts) 28(Suppl 15):5569Google Scholar

Copyright information

© Springer-Verlag 2010

Authors and Affiliations

  1. 1.Klinik und Poliklinik für Hals-, Nasen- und OhrenheilkundeUniversitätsklinik Hamburg-EppendorfHamburgDeutschland

Personalised recommendations