1037P - Docetaxel, carboplatin and fluoro-uracil (TCF) induction therapy in locally advanced head and neck squamous cell carcinoma (HNSCC) patients with con...

Date 01 October 2012
Event ESMO Congress 2012
Session Poster presentation III
Topics Anticancer agents
Head and Neck Cancers
Therapy
Biological Therapy
Presenter Esma Saada
Authors E. Saada1, F.R. Ferrand2, M. Fekih3, D. Hamdan4, F. Janot2, S. Temam3, M. Julieron2, A.M. Leridant2, A. Schilf2, J. Guigay5
  • 1Head And Neck Departement, institut Gustave Roussy, 94800 - villejuif/FR
  • 2Head And Neck Departement, institut Gustave Roussy, villejuif/FR
  • 3Head And Neck, institut Gustave Roussy, villejuif/FR
  • 4Oncologie Médicale, institut Gustave Roussy, villejuif/FR
  • 5institut Gustave Roussy, villejuif/FR

Abstract

Background

TPF regimen is a standard induction combination for fit locally advanced HNSCC patients (pts). TCF with carboplatin may be an option in frail pts with contraindication for cisplatin, but data are missing about safety and efficacy of such an approach.

Method

Retrospective study of monocentric cohort of HNSCC patients treated from 2007 to 2011 with TCF induction regimen at Gustave Roussy Institute. TCF regimen combined Docetaxel 75mg/m2, Carboplatin AUC4, and 5FU: 750 mg/m2/day for 5 days.

Results

Population included 34 pts, median age 59 years (44-78), all with Charlson Comorbidity Index score ≥ 2, with oropharynx, hypopharynx, oral cavity, larynx and paranasal sinuses HNSCC localization (32.3, 23.5, 17.6, 14.7 and 11.8% respectively). TNM stage were: T1-2 : 4 pts (11.7%), T3-4: 27 pts (79.4%), rTx: 3 pts (8.8%); N0: 8 pts (23.5%), N1: 4 pts (11.8%), N2a-N2b: 6 pts (17.6%), N2c-N3: 13 pts (38.2%); M1: 1 pt (2.9%). TPF contraindications were respiratory disease (di.) (11 pts: 32.3%), heart di. (6 pts: 17.6%), liver di. (3 pts: 8.8%), alcohol related neuropathy (3 pts: 8.8%), hearing di. (5 pts: 14.7%), renal di. (5 pts: 14.7%), other co-morbidities (3 pts: 8.8%).Patients received 2 to 4 cycles of TCF. GCSF was delivered in 31 pts (91.2%). Cumulated incidence of Grade 3-4 toxicity was 37.2%, and one toxic death occurred at C2. Five pts (14.7%) stopped treatment because of toxicity. RECIST evaluation found complete response in 1 patient (2.9%), partial response in 23 pts (67.6%), stable disease in 6 pts (17.7%), and progression disease in 1 pt (2.9%). Subsequent treatment was surgery followed by radiotherapy (9 pts, 26.5%), radiotherapy or chemoradiotherapy (22 pts, 64.7%), chemotherapy (3 pts, 8.8%). Response after RT was: CR: 16 pts (64%), PR: 4 pts (16 %), SD: 3 pts (12 %), PD: 2 pts (8 %). Median recurrence-free survival was 8.7 months, median overall survival (OS): 22.9 months. Personal history of cancer (HR = 4.6, p = 0.02), tobacco (HR = 37.5, p = 0.04), alcohol intake (HR = 0.12, p = 0.01), hypertension ( HR = 4.4, p = 0.01), T4 stage ( HR = 0.1, p = 0.02), N2c-N3 stage (HR = 18.5, p = 0.003), BMI < 20 (HR = 9.6, p = 0.02) and lymphopenia (HR = 4.3, p = 0.01) were associated with OS in multivariate analysis.

Conclusion

TCF induction regimen was manageable and provided objective responses in 70% of frail HNSCC patients.

Disclosure

All authors have declared no conflicts of interest.