TPF has been considered the standard regimen for induction chemotherapy (IC) for locally advanced SCCHN. Nevertheless, this combination is stressful to patients, and the continuous infusion of 5-FU reduces quality of life, owing not only to toxicity but also to inconvenience and catheter-related complications. Other options with improved safety profiles and greater convenience are thus highly desirable. In previous our phase I study (Tahara M, Ann Oncol 2011), TPS was well tolerated with highly promising activity. Here, we compare the efficacy and safety of TPS with TPF in locally advanced SCCHN.
We retrospectively reviewed medical records of 91 patients with locally advanced SCCHN treated with TPF or TPS followed by concurrent chemoradiotherapy (CRT) between 2009 and 2014. Median age 62 years, Oropharynx/hypopharynx/larynx: 46/31/14, TPF/TPS: 58/33. TPF consisted of docetaxel 70 mg/m2, CDDP 70 mg/m2, and 5-FU 750 mg/m2/day for 4 days, every 3 weeks, max 3 cycles. TPS consisted of docetaxel 70 mg/m2, CDDP 70 mg/m2, and S-1 60 mg/m2/day for 14 days, every 3 weeks, max 3 cycles.
Baseline characteristics of the patients were similar in the two treatment groups. Overall response rate of IC were 82.8% in TPF, 84.8% in TPS. After completion of CRT, complete response rate was 50.0% for TPF group and 69.7% for TPS group. Completion rate of radiotherapy with a total of 70 Gy was 93.1% for TPF and 93.9% for TPS. No difference in grade 3 or 4 toxicities was observed between two groups. With the median followed-up time of 2.74 years, 3yr PFS was 44.7% for TPF and 41.7% for TPS and OS were 67.6% for TPF and 55.0% for TPS.
Although this was not direct comparison, no difference in efficacy and safety between two groups was observed. TPS may be a good alternative option of IC for local advanced SCCHN.
Clinical trial identification
M. Tahara: personal fees from Merck Sharp & Dohme, Bristol-Myers Squibb, Bayer, Eisai, Otsuka, Merck Sereno, and grants from Boehringer Ingelheim, Astra Zeneca, outside the submitted work. All other authors have declared no conflicts of interest.