Abstract 454P
Background
Chemo-radiation is a well-established treatment for locally advanced head and neck squamous cell carcinoma (LAHNSCC), often utilizing cisplatin, which provides a survival advantage but with significant toxicity. Identifying patients unfit for cisplatin due to age, performance status, or pre-existing organ dysfunction is crucial. Docetaxel, a radiosensitizer, offers advantages including non-dependence on renal function and fewer long-term complications. This study presents our experience with Doce-Aquilip in cisplatin-ineligible patients.
Methods
Patients with LAHNSCC requiring adjuvant (post-op) or definitive chemo-radiation who were ineligible for cisplatin due to poor general condition or underlying cardiac/nephrological complications underwent CRT with Docetaxel. Radiation was administered at 1.8–2 Gy per fraction, 5 days a week, totaling 60 Gy adjuvantly and 66–70 Gy radically. Docetaxel was given intravenously at 15 mg/m2 weekly, with premedication of dexamethasone. Toxicity was monitored throughout CT-RT. Disease status was assessed 12 weeks post-treatment using MRI.
Results
Twenty patients (all male, median age 66) received Doce-Aquilip-based CRT, with seven in the adjuvant setting and eleven in the definitive setting. Causes of cisplatin ineligibility included CKD (30%), CAD (20%), poor general condition (20%), and metachronus malignancies (10%). Ninety-five percent completed the CT-RT course, with an average treatment duration of 51 days. Grade III mucositis occurred in 30%, Grade III dermatitis in 10%, and Grade III trismus in 5%, whereas Grade II mucositis was observed in 60%. Post-CRT MRI showed 45% with no evidence of disease, 25% with partial response, and 20% with disease progression/metastases. The mean survival was 456 days (95% CI: 360-551 days).
Conclusions
Doce-Aquilip concurrent CRT is a feasible alternative for cisplatin-ineligible LAHNSCC patients, offering manageable toxicity and promising response rates.
Clinical trial identification
Editorial acknowledgement
Legal entity responsible for the study
The authors.
Funding
Has not received any funding.
Disclosure
All authors have declared no conflicts of interest.