1041P - The tolerance of TPF chemotherapy regime standard or modified in head neck cancer patients over 65 years old

Date 01 October 2012
Event ESMO Congress 2012
Session Poster presentation III
Topics Anticancer agents
Geriatric Oncology
Head and Neck Cancers
Therapy
Biological therapy
Presenter Silvia Mihaela Ilie
Authors S.M. Ilie1, I. Ruginescu2, E. Saada2, F.R. Ferrand2, A. Schilf2, F. Janot2, J. Guigay3
  • 1Medical Oncology, Institute of Oncology Bucharest, Fundeni Clinical Hospital Alexandru Treistoreanu, 022328 - Bucharest/RO
  • 2Head And Neck Cancer Treatment, Institute Gustave Roussy, Villejuif/FR
  • 3Institute Gustave Roussy, Villejuif/FR

Abstract

Background

Docetaxel, Cisplatin, 5FU regimen (TPF) has became a standard for induction chemotherapy in locally advanced squamous cell cancer of head and neck (SCCHN). However, little is known about tolerance and efficacy of TPF in older patients Objective of the study was to evaluate the tolerance of induction chemotherapy with TPF regimen in SCCHN patients over 65 years, looking for side effects especially degree 3 and 4.

Materials and methods

retrospective study of the database of Head and Neck Cancer Department of Gustave Roussy Institute between 2006 and 2009: all patients over 65 years who received a TPF induction chemotherapy were included.

Results

Among 300 patients treated with TPF induction chemotherapy, we found 57 pts over 65 years : 41 (70%)between 65 - 70, 9 (15%)between 70 - 75 and 7 (12%)over 75. Most of patients received an organ preservation treatment for T3N0-1M0 hypopharynx and larynx cancer (52%) . 30 pts had an impaired nutritional status and 37(64%) an ACE 27 index superior of 2. 40 pts (70%) accomplished their planed cycles but only 37( 65%) received the planed doses. 23 pts (41%) presented a grade 3 or 4 hematological or gastrointestinal adverse events and 5 toxic deaths were observed.

Conclusion

This retrospective study confirms the high risk of toxicity of induction chemotherapy with TPF combination in elderly SCCHN patients that may compromise the postsurgical outcome in patients over 65 years presenting at least one comorbidity and denutrition. Geriatric assessment is probably useful in this population to better select candidates to induction chemotherapy.

Disclosure

All authors have declared no conflicts of interest.