999P - Neoadjuvant (NA) chemotherapy (CT) with docetaxel, cisplatin and 5-fluorouracil (TPF) before concomitant chemoradiation (CCR) for patients (pts) wi...

Date 29 September 2014
Event ESMO 2014
Session Poster Display session
Topics Anti-Cancer Agents & Biologic Therapy
Head and Neck Cancers
Surgery and/or Radiotherapy of Cancer
Presenter Joao Lopes
Citation Annals of Oncology (2014) 25 (suppl_4): iv340-iv356. 10.1093/annonc/mdu340
Authors J.M. Lopes, A. Mayer, D.A. Costa, E.J. Gouveia, I. Miguel, M. Carneiro, P. Winckler Barosa Andrade, L. Martins, P. Nicolau, V. Ribeiro, M.T.A. Alexandre, I. Sargento, M. Ferreira, A. Moreira
  • Medical Oncology, Instituto Portuguès de Oncologia de Lisboa Francisco Gentil, E.P.E. (IPOLFG EPE), 1099-023 - Lisboa/PT

Abstract

Aim

2/3 of the pts with SCCHN present in advanced stages (III and IV). Since 2007, in some centres, the standard of care for LA SCCHN is NA CT with TPF, followed by CCR. This approach has led to improved progression-free (PFS) and overall (OS) survival at the expense of greater toxicity (Tx). In 2012 we started at our institution an INLSP and all consecutive pts were enrolled. We present our updated Tx results.

Methods

Pts were treated with Docetaxel 75mg/m2 (day 1), Cisplatin 75mg/m2 (day 1) and 5-Fluorouracil 750mg/m2/day (days 1-5) for 3 cycles, followed by CCR. The clinical records of all pts were retrospectively reviewed and demographical, epidemiological and clinical data were retrieved. We evaluated efficacy using clinical criteria and Tx using Common Terminology Criteria for Adverse Events 4.0. Treatment-related deaths, emergency room visits and hospital admissions were analyzed. Statistical analysis was performed using STATA (R).

Results

Between July 2008 and March 2014 147 pts were treated at our institution (88% male). Mean age at diagnosis was 53 years-old. 95% of the pts had ECOG PS 0 or 1. The most common primary tumor locations were oropharynx (48%), hypopharynx (26%) and oral cavity (20%). The majority had stage IVA (52%) or IVB (46%) disease. Tobacco (95.9%) and Alcohol (93.2%) use were the most common comorbidities. 44.2% of the analyzed pts were enrolled on our INLSP. Pts received a mean number of 2.74 cycles of TPF. Overall clinical response rate (cRR) with TPF was 90.5%, with a Complete cRR of 19.1%. Most common adverse events (all grades) were anemia (43.5%) and diarrhea (25.2%). 25.2% of the pts experienced grade 3-4 Tx (mainly neutropenia and diarrhea). Seven pts died as a result of the treatment (4.8%). Pts enrolled on our INLSP experienced fewer grade 3-4 events (18.5 vs 30.5%), treatment-related deaths (4.6 vs 5.1%), emergency room visits (35.4 vs 40.2%) and hospital admissions (30.8 vs 34.1%), but differences were not statistically significant.

Conclusions

NA CT with TPF followed by CCR is an effective treatment for pts with LA SCCHN. Tx is important. These pts should be treated at high-volume, experienced institutions. Our RR and Tx rates are comparable to other published series. Our INLSP improves Tx results, even though differences are still nonsignificant.

Disclosure

All authors have declared no conflicts of interest.