Séna Yossi1,2,3, Benjamin Linot4, Guillaume Peyraga4,5, Renaud Breheret6, Laurent Laccourreye6, Olivier Capitain4. 1. Department of Oncopharmacology-Pharmacogenetics, Integrated Center of Oncology (ICO) Paul Papin, 2 rue Moll, 49033, Angers Cedex 9, France. senyo@wanadoo.fr. 2. Radiotherapy Department, Centre Hospitalier Lyon Sud, 165 Chemin du Grand Revoyet, 69495, Pierre bénite, France. senyo@wanadoo.fr. 3. Radiotherapy Department, Integrated Center of Oncology (ICO) Paul Papin, 2 rue Moll, 49033, Angers Cedex 9, France. senyo@wanadoo.fr. 4. Department of Oncopharmacology-Pharmacogenetics, Integrated Center of Oncology (ICO) Paul Papin, 2 rue Moll, 49033, Angers Cedex 9, France. 5. Radiotherapy Department, Integrated Center of Oncology (ICO) Paul Papin, 2 rue Moll, 49033, Angers Cedex 9, France. 6. Head and Neck Surgery Department, Centre Hospitalier Universitaire, 4 Rue Larrey, 49100, Angers, France.
Abstract
BACKGROUND: Docetaxel-cisplatin and 5-fluorouracil (TPF) chemotherapy (days 1-21) represents a standard but toxic regimen for advanced head and neck cancer (HNC). We report a retrospective monocentric study evaluating the safety and the efficacy of a dose-dense modified TPF (mTPF) regimen (days 1-14) in patients with stage III-IV HNC. METHODS: Thirty-seven patients retrospectively included from May 2011 to May 2014 were treated with a bimonthly dose-dense mTPF regimen (40 mg/m(2) docetaxel, 40 mg/m(2) cisplatin or AUC2 carboplatin, folinic acid 400 mg/m(2) for 2 h, bolus 5-FU 400 mg/m(2) for 10 min and 5-FU 1,000 mg/m(2)/day) by continuous infusion over 46 h). RESULTS: Chemotherapy was used as induction or palliative treatment in 12 and 25 patients, respectively, with a median age of 60 years (range 46-83). Median follow-up time was 7.4 months (2.53-16.7 months). There was no intestinal toxicity in 25 patients (68 %). Grade 3-4 hematological toxicity was noticed for 5 (13.5 %) patients. Granulocyte-colony stimulating factor was used as primary prophylaxis in 30 patients (81 %). After at least 4 delivered cycles, complete responses, partial responses and stable diseases were reported in 5 (15 %), 13 (39 %) and 5 (15 %) of the 33 evaluable patients, respectively, yielding an objective response rate of 54.5 % (39 % for palliative chemotherapy and 90 % for induction chemotherapy). CONCLUSION: Dose-dense mTPF (days 1-14) is safe and seems to be as effective as TPF (days 1-21). Future prospective trials are required to confirm our results.
BACKGROUND:Docetaxel-cisplatin and 5-fluorouracil (TPF) chemotherapy (days 1-21) represents a standard but toxic regimen for advanced head and neck cancer (HNC). We report a retrospective monocentric study evaluating the safety and the efficacy of a dose-dense modified TPF (mTPF) regimen (days 1-14) in patients with stage III-IV HNC. METHODS: Thirty-seven patients retrospectively included from May 2011 to May 2014 were treated with a bimonthly dose-dense mTPF regimen (40 mg/m(2) docetaxel, 40 mg/m(2) cisplatin or AUC2 carboplatin, folinic acid 400 mg/m(2) for 2 h, bolus 5-FU 400 mg/m(2) for 10 min and 5-FU 1,000 mg/m(2)/day) by continuous infusion over 46 h). RESULTS: Chemotherapy was used as induction or palliative treatment in 12 and 25 patients, respectively, with a median age of 60 years (range 46-83). Median follow-up time was 7.4 months (2.53-16.7 months). There was no intestinal toxicity in 25 patients (68 %). Grade 3-4 hematological toxicity was noticed for 5 (13.5 %) patients. Granulocyte-colony stimulating factor was used as primary prophylaxis in 30 patients (81 %). After at least 4 delivered cycles, complete responses, partial responses and stable diseases were reported in 5 (15 %), 13 (39 %) and 5 (15 %) of the 33 evaluable patients, respectively, yielding an objective response rate of 54.5 % (39 % for palliative chemotherapy and 90 % for induction chemotherapy). CONCLUSION: Dose-dense mTPF (days 1-14) is safe and seems to be as effective as TPF (days 1-21). Future prospective trials are required to confirm our results.
Entities:
Keywords:
5-fluorouracil; Cisplatin; Docetaxel; Dose-dense chemotherapy; Head and neck cancer; Quality of life
Authors: Eric Van Cutsem; Vladimir M Moiseyenko; Sergei Tjulandin; Alejandro Majlis; Manuel Constenla; Corrado Boni; Adriano Rodrigues; Miguel Fodor; Yee Chao; Edouard Voznyi; Marie-Laure Risse; Jaffer A Ajani Journal: J Clin Oncol Date: 2006-11-01 Impact factor: 44.544
Authors: Jan B Vermorken; Eva Remenar; Carla van Herpen; Thierry Gorlia; Ricard Mesia; Marian Degardin; John S Stewart; Svetislav Jelic; Jan Betka; Joachim H Preiss; Danielle van den Weyngaert; Ahmad Awada; Didier Cupissol; Heinz R Kienzer; Augustin Rey; Isabelle Desaunois; Jacques Bernier; Jean-Louis Lefebvre Journal: N Engl J Med Date: 2007-10-25 Impact factor: 91.245
Authors: Marshall R Posner; Diane M Hershock; Cesar R Blajman; Elizabeth Mickiewicz; Eric Winquist; Vera Gorbounova; Sergei Tjulandin; Dong M Shin; Kevin Cullen; Thomas J Ervin; Barbara A Murphy; Luis E Raez; Roger B Cohen; Monica Spaulding; Roy B Tishler; Berta Roth; Rosana del Carmen Viroglio; Varagur Venkatesan; Ilya Romanov; Sanjiv Agarwala; K William Harter; Matthew Dugan; Anthony Cmelak; Arnold M Markoe; Paul W Read; Lynn Steinbrenner; A Dimitrios Colevas; Charles M Norris; Robert I Haddad Journal: N Engl J Med Date: 2007-10-25 Impact factor: 91.245
Authors: Yoann Pointreau; Pascal Garaud; Sophie Chapet; Christian Sire; Claude Tuchais; Jacques Tortochaux; Sandrine Faivre; Stephane Guerrif; Marc Alfonsi; Gilles Calais Journal: J Natl Cancer Inst Date: 2009-03-24 Impact factor: 13.506
Authors: Martina Baur; Heinz-Roland Kienzer; Johannes Schweiger; Maria DeSantis; Erich Gerber; Jörg Pont; Marcus Hudec; Annemarie Ulrike Schratter-Sehn; Wolfram Wicke; Christian Dittrich Journal: Cancer Date: 2002-06-01 Impact factor: 6.860