Induction chemotherapy with docetaxel, cisplatin and 5-fluorouracil followed by radiotherapy with cetuximab for locally advanced squamous cell carcinoma of the head and neck
Menée sur 49 patients atteints d'un carcinome épidermoïde de la tête et du cou localement avancé de stade III ou IV, cette étude évalue, du point de vue de la survie sans progression et de la survie globale à deux ans, l'efficacité et la toxicité d'un protocole thérapeutique comportant trois cycles de chimiothérapie d'induction par docétaxel-cisplatine-5-fluorouracile puis une radiothérapie concomitante combinée au cetuximab
Purpose To determine the efficacy and feasibility of induction chemotherapy (ICT) with docetaxel, cisplatin and 5-fluorouracil followed by radiotherapy and cetuximab (C) in patients with locally advanced head and neck cancer. Patients and methods Forty-nine previously untreated patients with local advanced stage III and IV squamous cell carcinoma of the head and neck (SCCHN) received three courses of ICT consisting of docetaxel 75 mg/m2 day 1, cisplatin 75 mg/m2 day 1 and infusional 5-fluorouracil 750 mg/m2/day on days 1–5 followed by radiotherapy plus C at 250 mg/m2/week (after an initial loading dose of 400 mg/m2). Results After completion of ICT 44 of 49 patients received radiotherapy plus C. Three months after therapy completion tumour response was observed in 33 patients and after two years, 25 patients were in complete remission (CR). The most common grade 4 toxicity during the whole treatment period was dermatitis (30%), followed by mucositis (27%) and neutropenia (17%) without fever. One toxic related death was observed during ICT. Two-year progression-free survival (PFS) rate was 59% and two-year overall survival (OS) rate was 63%, respectively. Conclusion Concurrent radiotherapy plus C after three courses of ICT was feasible and was associated with promising CR, PFS and OS rates. Further optimisation of dose and sequence is warranted.