Induction treatment with Docetaxel/Cisplatin/5-FU (TPF) in TAX 324 study was evaluated from 3 mixed groups of patients (technical unresectibility, low surgical curability and organ preservation). Conversely, most of LAHNC patients in our center are unresectibility. This study was intended to evaluate the outcomes of induction TPF followed by CCRT in unresectable LAHNC.
Between January 2009 and December 2013, we retrospectively analyzed the outcomes in 30 unresectable LAHNC patients who received induction TPF (Docetaxel 75 mg/m2 on day 1, Cisplatin 75 mg/m2 on day 1, 5-fluorouracil 750 mg/m2 on day 1-4, every 3 weeks), followed by CCRT with weekly Carboplatin (AUC 2) at Maharaj Nakorn Chiang Mai Hospital.
Most of the patients were male (97%) with a median age of 52.1 years (range 47.8–55.9). All patients had good performance status (ECOG 0-1). Site of cancer consisted of oropharynx 53%, hypopharynx 37%, larynx 7% and oral cavity 3%. Squamous cell carcinoma was found in 97%. Seventy – four percent of patients completely received 3 cycles of induction TPF and 81% completely received at least 5 cycles of concurrent carboplatin. With the median follow-up of 12.4 months, the median survival was 12 months. No patients in our study received salvage surgery even having residual disease or N2/N3 at diagnosis. The 2-year overall survival and disease-free survival were 40% and 59%, respectively. We found grade 3-4 neutropenia in 20% of patients, and grade 3 thrombocytopenia in 3% of patients.
Our induction TPF followed by CCRT outcomes were inferior to TAX 324 study. We believe that salvage surgery may have the role in this group of patients.
Clinical trial identification
All authors have declared no conflicts of interest.