Cancer Res Treat.  2007 Mar;39(1):1-5.

Induction Chemotherapy of Docetaxel and Cisplatin for the Elderly Patients with Squamous Cell Carcinoma of the Head and Neck

• Choi YJ
• Chung J
• Shin HJ
• Cho GJ
• Wang SG
• Lee BJ
• Cho BM
• Kim DW
• Kim HJ
• Lee WS
• Joo YD
• Sohn CH

Abstract

PURPOSE: Although concurrent chemoradiotherapy (CCRT) has been considered as a standard treatment for locally advanced squamous cell carcinoma of the head and neck (SCCHN), this treament is associated with increased toxicities such as mucositis and dermatitis. As a result, the dose intensity can be reduced and interruptions of radiotherapy are more common for CCRT than for sequential treatment, especially for the elderly patients. This prospective study was performed to assess the efficacy and safety profiles of the induction chemotherapy of docetaxel and cisplatin for elderly patients with locally advanced SCCHN.
MATERIALS AND METHODS
Patients over 65 years of age with locally advanced SCCHN were treated with docetaxel (70 mg/m(2)) and cisplatin (75 mg/m(2)) every 21 days. The chemotherapy consisted of two cycles with a third cycle that was administered to the responding patients. Patients who did not respond to initial chemotherapy underwent radiotherapy as a definitive local treatment.
RESULTS
Fifty patients were enrolled in this study and 44 patients were assessable for response and toxicity. The overall response rate was 88%, 16 patients (36%) achieved a complete response and 23 patients (52%) achieved a partial response. After a median follow-up of 24 months (range: 9~38 months) the median disease free period and overall survival period had not yet been reached. The one year and two year survival rates were 89% and 70%, respectively. The most common grade 3/4 adverse event was neutropenia, which occurred in 33 patients (75%) and 4 patients had febrile neutropenia.
CONCLUSION
Combination chemotherapy of docetaxel and cisplatin is an effective regimen with an acceptable safety profile as the induction treatment for elderly patients suffering with SCCHN.

Keyword

Docetaxel; Cisplatin; Head and neck cancer; Induction chemtherapy

MeSH Terms

Aged*
Carcinoma, Squamous Cell*
Chemoradiotherapy
Cisplatin*
Dermatitis
Drug Therapy
Drug Therapy, Combination
Febrile Neutropenia
Follow-Up Studies
Head and Neck Neoplasms
Head*
Humans
Induction Chemotherapy*
Mucositis
Neck*
Neutropenia
Prospective Studies
Radiotherapy
Survival Rate
Cisplatin

Reference

1. Parkin DM, Pisani P, Ferlay J. Estimates of the worldwide incidence of 25 major cancers in 1990. Int J Cancer. 1999; 80:827–841. PMID: 10074914.

2. Zbaren P, Lehmann W. Frequency and sites of distant metastases in head and neck squamous cell carcinoma. Arch Otolaryngol Head Neck Surg. 1987; 113:762–764. PMID: 3580159.

3. Ries LA, Eisner MP, Kosary CL. SEER Cancer Statistics Review, 1975~2000. 2003. Bethesda, MD: National Cancer Institute.

4. Pignon JP, Bourhis J, Domenge C, Designe L. Chemotherapy added to locoregional treatment for head and neck squamous-cell carcinoma: Three meta-analyses of updated individual data. MACH-NC collaborative group. Meta-analysis of chemotherapy on head and neck cancer. Lancet. 2000; 355:949–955. PMID: 10768432.

5. Cohen EE, Lingen MW, Vokes EE. The expanding role of systemic therapy in head and neck cancer. J Clin Oncol. 2004; 22:1743–1752. PMID: 15117998.

6. Vokes EE, Stenson K, Rosen FR, Kies MS, Rademaker AW, Witt ME, et al. Weekly carboplatin and paclitaxel followed by concomitant paclitaxel, fluorouracil, and hydroxyurea chemoradiotherapy: curative and organ-preserving therapy for advanced head and neck cancer. J Clin Oncol. 2003; 21:320–326. PMID: 12525525.

7. Lefebvre JL, Chevalier D, Luboinski B, Kirkpatrick A, Collette L, Sahmoud T. 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. 1996; 88:890–899. PMID: 8656441.

8. Licitra L, Grandi C, Guzzo M, Mariani L, Lo Vullo S, Valvo F, et al. Primary chemotherapy in resectable oral cavity squamous cell cancer: a randomized controlled trial. J Clin Oncol. 2003; 21:327–333. PMID: 12525526.

9. Domenge C, Hill C, Lefebvre JL, De Raucourt D, Rhein B, Wibault P, et al. Randomized trial of neoadjuvant chemotherapy in oropharyngeal carcinoma: French Groupe d'Etude des Tumeurs de la Tete et du Cou (GETTEC). Br J Cancer. 2000; 83:1594–1598. PMID: 11189100.

10. Schöffski P, Catimel G, Planting AS, Droz JP, Verweij J, Schrijvers D, et al. Docetaxel and cisplatin: an active regimen in patients with locally advanced, recurrent or metastatic squamous cell carcinoma of the head and neck. Results of a phase II study of the EORTC early clinical studies group. Ann Oncol. 1999; 10:119–122. PMID: 10076732.

11. Glisson BS, Murphy BA, Frenette G, Khuri FR, Forastiere AA. Phase II trial of docetaxel and cisplatin combination chemotherapy in patients with squamous cell carcinoma of the head and neck. J Clin Oncol. 2002; 20:1593–1599. PMID: 11896109.

12. Therasse P, Arbuck SG, Eisenhauer EA, Wanders J, Kaplan RS, Rubinstein L, et al. New guidelines to evaluate the response to treatment in solid tumors. J Natl Cancer Inst. 2000; 92:205–216. PMID: 10655437.

12. National Cancer Institute Common Toxicity Criteria. [On-line]. National Cancer Institute. http://ctep.info.nih.gov/reporting/index.html.

14. Ozols RF, Masuda H, Hamilton TC. Mechanisms of cross-resistance between radiation and antineoplastic drugs. NCI Monogr. 1988; 6:159–165. PMID: 3352759.

15. Ensley JF, Jacobs JR, Weaver A, Kinzie J, Crissman J, Kish JA, et al. Correlation between response to cisplatinum-combination chemotherapy and subsequent radiotherapy in previously untreated patients with advanced squamous cell cancers of the head and neck. Cancer. 1984; 54:811–814. PMID: 6204738.

16. Browman GP. Evidence-based recommendations against neoadjuvant chemotherapy for routine management of patients with squamous cell head and neck cancer. Cancer Invest. 1994; 12:662–670. PMID: 7994602.

17. Brockstein B, Haraf DJ, Rademaker AW, Kies MS, Stenson KM, Rosen F, et al. Patterns of failure, prognostic factors and survival in locoregionally advanced head and neck cancer treated with concomitant chemoradiotherapy: a 9-year, 337-patient, multi-institutional experience. Ann Oncol. 2004; 15:1179–1186. PMID: 15277256.

18. Dreyfuss AI, Clark JR, Norris CM, Rossi RM, Lucarini JW, Busse PM, et al. Docetaxel: an active drug for squamous cell carcinoma of the head and neck. J Clin Oncol. 1996; 14:1672–1678. PMID: 8622087.

19. Catimel G, Verweij J, Mattijssen V, Hanauske A, Piccart M, Wanders J, et al. EORTC early clinical trials group. Docetaxel (Taxotere): an active drug for the treatment of patients with advanced squamous cell carcinoma of the head and neck. Ann Oncol. 1994; 5:533–537. PMID: 7918125.

20. Colevas AD, Busse PM, Norris CM, Fried M, Tishler RB, Poulin M, et al. Induction chemotherapy with docetaxel, cisplatin, fluorouracil, and leucovorin for squamous cell carcinoma of the head and neck: a phase I/II trial. J Clin Oncol. 1998; 16:1331–1339. PMID: 9552034.

21. Vermorken JB, Remenar E, Van Herpen C. Standard cisplatin/infusional 5-fluorouracil (PF) vs docetaxel (T) plus PF (TPF) as neoadjuvant chemotherapy for nonresectable locally advanced squamous cell carcinoma of the head and neck (LA-SCCHN): a phase III trial of the EORTC head and neck cancer group. Proc Am Soc Clin Oncol. 2004; 23:(abstr 5508).

22. Clavel M, Vermorken JB, Cognetti F, Cappelaere P, de Mulder PH, Schornagel JH, et al. Randomized comparison of cisplatin, methotrexate, bleomycin and vincristine (CABO) versus cisplatin and 5-fluorouracil (CF) versus cisplatin (C) in recurrent or metastatic squamous cell carcinoma of the head and neck. A phase III study of the EORTC head and neck cancer cooperative group. Ann Oncol. 1994; 5:521–526. PMID: 7522527.

23. Gebbia V, Di Marco P, Citarrella P. Systemic chemotherapy in elderly patients with locally advanced and/or inoperable squamous cell carcinoma of the head and neck: impact of anemia and role of recombinant human erythropoietin. Crit Rev Oncol Hematol. 2003; 48(Suppl):S49–S55. PMID: 14563521.