Response Rate and Toxicity of Docetaxel / Cisplatin /5FU in Comparison with Cisplatin / 5FU Induction Chemotherapy in Locally Advanced Head and Neck Squamous Cell Carcinoma
Abstract
Background: Response to chemotherapy is a reliable marker for radiation sensitivity in patients with locally advanced head and neck squamous cell carcinoma. We compared the response rate and toxicity after two cycles of chemotherapy using Docetaxel / Cisplatin /5FU or Cisplatin / 5FU among these patients.
Methods: We randomly assigned 16 to 75 years old patients with stage III or IV non-metastatic locally advanced head and neck squamous cell carcinoma to receive either DCF or CF every 3 weeks for two cycles. All patients who received at least one and two cycles of chemotherapy were considered for toxicity and response evaluation respectively.
Results: Seventy patients underwent randomization, 36 and 34 patients were assigned to Docetaxel / Cisplatin /5FU and Cisplatin / 5FU groups respectively. Three and 8 patients were excluded after randomization and before receiving any chemotherapy in Docetaxel / Cisplatin /5FU and Cisplatin / 5FU groups respectively. Finally 30 and 25 in Docetaxel / Cisplatin /5FU group and 25 and 23 patients in Cisplatin / 5FU group were evaluated for toxicity and response respectively. Response rate (complete and partial response) was %83 (35% complete and 48% partial response) and %84(16% complete and 68% partial response) in Cisplatin / 5FU and Docetaxel / Cisplatin /5FU groups respectively (P= 0.28). There was no differences in complete response rate between two groups (P=0.18). Neutropenia, phlebitis and mucositis were more common in Cisplatin / 5FU group without statistically significant difference. Constipation was significantly more common in Cisplatin / 5FU group (P= 0.008). Diarrhea, alopecia and febrile neutropenia were significantly more common in Docetaxel / Cisplatin /5FU group (P= 0.006, 0.01 and 0.03 respectivly).
Conclusion:
We could not find any significant differences between response to Docetaxel / Cisplatin /5FU and Cisplatin /5FU combination chemotherapy among Iranian patients with locally advanced head and neck squamous cell carcinoma. However, for better evaluation, larger studies with better designs are being conducted in our center.
Methods: We randomly assigned 16 to 75 years old patients with stage III or IV non-metastatic locally advanced head and neck squamous cell carcinoma to receive either DCF or CF every 3 weeks for two cycles. All patients who received at least one and two cycles of chemotherapy were considered for toxicity and response evaluation respectively.
Results: Seventy patients underwent randomization, 36 and 34 patients were assigned to Docetaxel / Cisplatin /5FU and Cisplatin / 5FU groups respectively. Three and 8 patients were excluded after randomization and before receiving any chemotherapy in Docetaxel / Cisplatin /5FU and Cisplatin / 5FU groups respectively. Finally 30 and 25 in Docetaxel / Cisplatin /5FU group and 25 and 23 patients in Cisplatin / 5FU group were evaluated for toxicity and response respectively. Response rate (complete and partial response) was %83 (35% complete and 48% partial response) and %84(16% complete and 68% partial response) in Cisplatin / 5FU and Docetaxel / Cisplatin /5FU groups respectively (P= 0.28). There was no differences in complete response rate between two groups (P=0.18). Neutropenia, phlebitis and mucositis were more common in Cisplatin / 5FU group without statistically significant difference. Constipation was significantly more common in Cisplatin / 5FU group (P= 0.008). Diarrhea, alopecia and febrile neutropenia were significantly more common in Docetaxel / Cisplatin /5FU group (P= 0.006, 0.01 and 0.03 respectivly).
Conclusion:
We could not find any significant differences between response to Docetaxel / Cisplatin /5FU and Cisplatin /5FU combination chemotherapy among Iranian patients with locally advanced head and neck squamous cell carcinoma. However, for better evaluation, larger studies with better designs are being conducted in our center.