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Efficacy and feasibility of docetaxel, cisplatin, and 5-fluorouracil induction chemotherapy for locally advanced head and neck squamous cell carcinoma classified as clinical nodal stage N2c, N3, or N2b with supraclavicular lymph node metastases

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Abstract

Background

We evaluated the efficacy and feasibility of docetaxel, cisplatin, and 5-fluorouracil (TPF) induction chemotherapy followed by concurrent chemoradiotherapy (CRT) for locally advanced head and neck squamous cell carcinoma (HNSCC) with a high risk of distant metastases compared with CRT alone.

Methods

We retrospectively analyzed 29 HNSCC patients with clinical nodal stage N2c, N3, or N2b disease and supraclavicular lymph node metastases receiving CRT alone (CRT group; n = 16) or TPF induction chemotherapy followed by CRT (TPF group; n = 13) between April 2008 and May 2012.

Results

The median follow-up periods were 14.5 (range 5.0–65.0) and 25.0 (range 14.0–32.0) months for CRT and TPF groups, respectively. A greater proportion of patient characteristics in the CRT group had advanced T and N stages. The overall response rate to induction TPF was 50.0 %; grade 3–4 toxicities included neutropenia, febrile neutropenia, anorexia, and hyponatremia. Complete response rates after CRT completion were 55.5 % in the TPF and 42.9 % in the CRT group; median overall survival was not reached in the TPF group and was 14.0 months in the CRT group (p = 0.037). Multivariate analysis revealed that induction TPF and T stage were independent prognostic factors [hazard ratio (HR) = 0.196; 95 % confidence interval (CI) 0.043–0.898; p = 0.036, HR = 9.966; 95 % CI 2.270–43.75; p = 0.002, respectively).

Conclusion

TPF followed by CRT is tolerated and may be an option for the treatment of locally advanced stage N2c, N3, or N2b HNSCC.

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Conflict of interest

Narikazu Boku received a research grant from Taiho and Chugai and lecture fees from Taiho, Chugai, and Shionogi. Tomoya Yokota serves as a consultant to AstraZeneca and receives lecture fees from Merck Serono and Bristol-Myers Squibb. The other authors have no conflict of interest.

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Authors and Affiliations

  1. Division of Gastrointestinal Oncology, Shizuoka Cancer Center, 1007 Shimonagakubo Nagaizumi Sunto-gun, Shizuoka, 411-8777, Japan

    Naoki Izawa, Yusuke Onozawa, Tomomi Hikosaka, Satoshi Hamauchi, Takahiro Tsushima, Akiko Todaka, Nozomu Machida, Yutaka Haraguchi, Hirofumi Yasui & Tomoya Yokota

  2. Division of Medical Oncology, Shizuoka Cancer Center, 1007 Shimonagakubo Nagaizumi Sunto-gun, Shizuoka, 411-8777, Japan

    Yusuke Onozawa

  3. Division of Radiation Oncology, Shizuoka Cancer Center, 1007 Shimonagakubo Nagaizumi Sunto-gun, Shizuoka, 411-8777, Japan

    Hirofumi Ogawa & Tetsuo Nishimura

  4. Division of Plastic and Reconstructive Surgery, Shizuoka Cancer Center, 1007 Shimonagakubo Nagaizumi Sunto-gun, Shizuoka, 411-8777, Japan

    Masahiro Nakagawa

  5. Division of Head and Neck Surgery, Shizuoka Cancer Center, 1007 Shimonagakubo Nagaizumi Sunto-gun, Shizuoka, 411-8777, Japan

    Tomohito Fuke, Yoshiyuki Iida, Tomoyuki Kamijo & Tetsuro Onitsuka

  6. Division of Clinical Oncology, St. Marianna University School of Medicine, 2-16-1 Sugao Miyamae-ku, Kawasaki, 216-8511, Japan

    Naoki Izawa & Narikazu Boku

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  1. Naoki Izawa
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  2. Yusuke Onozawa
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  16. Narikazu Boku
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  17. Hirofumi Yasui
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  18. Tomoya Yokota
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Corresponding author

Correspondence to Tomoya Yokota.

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Izawa, N., Onozawa, Y., Hikosaka, T. et al. Efficacy and feasibility of docetaxel, cisplatin, and 5-fluorouracil induction chemotherapy for locally advanced head and neck squamous cell carcinoma classified as clinical nodal stage N2c, N3, or N2b with supraclavicular lymph node metastases. Int J Clin Oncol 20, 455–462 (2015). https://doi.org/10.1007/s10147-014-0749-4

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  • DOI: https://doi.org/10.1007/s10147-014-0749-4

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