Paclitaxel as induction chemotherapy plus radiation for locally advanced sequamous cell carcinoma of the head and neck

ABSTRACT

The primary objective of this study was to asses the complete response [CR] rate to a new innovative induction regimen plus combined chemoradiation in patients with locally advanced head and neck cancer [LA-HNC]. From April 2003 to March 2005, 66 eligible patients with LA-HNC referred mainly from Oncosurgery Department to Clinical Oncology and Nuclear Medicine Department, Mansoura University Hospital were treated by three cycles of induction chemotherapy [IC] with paclitaxel 175mg/m[2] in 3-h infusion on d1, leucovorin [LV] 200mg/m[2] over 20min immediately followed by fluorouracil [FU] 400mg/m[2] bolus and then 600mg/m[2] as 24h continuous infusion on d1 and 2, cisplatin 75mg/m[2] over 1-h infusion on d2 every 3 weeks. This was followed by radiation [70Gy] am weekly cisplatin 20mg/m[2]. After the completion of IC, 12/66 [18.2%] patient had CR. The CR rate was increased to [53.03%] post concomitant chemoradiotherapy [CCRT]. Hematologic toxicity, alopecia and mucositis were the most common complications of treatment. Median time to progression was 10 months and median survival was 18 months. This novel induction regimen is active, well tolerated and can be successfully followed by CCRT with weekly cisplatin. CCRT should remain standard treatment for patients with LA-HNC