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The outcomes of induction chemotherapy for head and neck cancer patients

Date

20 Dec 2015

Session

Poster presentation 2

Presenters

Szu-Yuan Wu

Citation

Annals of Oncology (2015) 26 (suppl_9): 93-102. 10.1093/annonc/mdv527

Authors

S. Wu1, F. Lee2, K. Lin3, K. Yuan2

Author affiliations

  • 1 Department Of Radiation Oncology, Wan Fang Hospital, Taipei Medical University, Taipei, Taiwan., 116 - Taipei/TW
  • 2 Department Of Otorhinolaryngology, Wan Fang Hospital, Taipei Medical University, Taipei, Taiwan, Taipei/TW
  • 3 Department Of Oral And Maxillofacial Surgery, Wan Fang Hospital, Taipei Medical University, Taipei, Taiwan, Taipei/TW
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Aim/Background

Till now, the role of induction chemotherapy has remained a subject of controversy. Our study was to directly compare survival in patients receiving induction chemotherapy docetaxel or platinum given before concomitant chemoradiotherapy with upfront chemoradiotherapy alone.

Methods

The National Health Insurance claims database and cancer registry databases in Taiwan were linked for the analysis. Head and neck cancer patients from January 1, 2002 to December 31, 2011 were included in the study. The inclusion criteria were having a head and neck cancers, being aged > 20 years, American Joint Committee on Cancer clinical cancer stage III ∼ IV and having undergone induction chemotherapy or concurrent platinum based chemoradiotherapy (CCRT). Exclusion criteria were having been diagnosed with cancer before the head and neck cancer was confirmed, having distant metastasis, platinum and docetaxel combined use before RT, docetaxel use during/after RT, induction chemotherapy beyond 8 weeks before RT, cetuximab use, adjuvant chemotherapy within 90 days after completion of RT, < 7,000 cGy dose of RT, curative surgery before RT, nasopharyngeal cancer, carcinoma in situ, sarcoma, head and neck cancer recurrence, or an unknown gender, and being younger than 20 years.

Results

In total, 10,721 stage III ∼ IV head and neck cancer patients without distant metastasis were included in the study. There were 7,968 patients in the CCRT group (arm 1); 503 patients in the induction chemotherapy with docetaxel group of arm 2 and 2,232 patients in the induction chemotherapy with platinum group of arm 3. We used the CCRT arm as the control arm to investigate the risk of death after induction chemotherapy. After adjustments for age, gender, clinical stage, and comorbidities, the aHRs of overall deaths were 1.37 (95% CI, 1.22–1.53) in arm 2 and 1.44 (95% CI, 1.36–1.52) in arm 3. In disease-specific survival rate analysis, after adjustments for age, gender, clinical stage, and comorbidities, the aHRs of head and neck cancers deaths were 1.29 (95% CI, 1.14-1.46) in arm 2 and 1.47 (95% CI, 1.38-1.56) in arm 3.

Conclusions

Our cohort study showed induction chemotherapy with docetaxel or platinum not only did not improve survival but also result in more all death and head and neck cancer death risk compared with CCRT.

Clinical trial identification

not a clinical trial

Disclosure

All authors have declared no conflicts of interest.

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