Induction Chemotherapy with Cisplatin, Paclitaxel, and Capecitabine (PTC) in Locally Advanced (LA) Squamous Cell Carcinoma of Head and Neck (SCCHN)

ABSTRACT

Purpose/Objective(s) In Guatemala's Roosevelt Hospital, most patients consult with locally advanced stages of SCCHN. Cisplatin, Docetaxel, and 5FU regimen has shown superiority over Cisplatin plus 5FU during the induction of LA cases, with afew reports supporting the substitution of 5FU with capecitabine for LA SCCHN. During the COVID-19 pandemic, we performed induction therapy with PTC in patients with LA SCCHN to reduce inpatient treatment. Materials/Methods We performed a retrospective analysis of patients with LA SCCHN with preserved swallowing function treated with Cisplatin 75mg/m2, Paclitaxel 175mg/m2, and Capecitabine 1000mg/m2 twice a day for 14 days. RECIST and CTCAE were used to measure response and adverse events. Results A total of 16 LA SCCHN patients were treated with PTC induction. Treated patients were mostly men, smokers, and considered not candidates for surgical resection (Table 1). The mean of cycles administered was 3.5 (SD = 0.97). Regarding the response to the PTC regimen, 93.6% of patients achieved disease control. Only 6.2% of patients stopped capecitabine, whereas 37.5% required dose reduction. The main adverse events were nausea, vomiting, and diarrhea. Conclusion The PTC regimen worked as induction therapy for patients with LA SCCHN. The substitution of 5FU for Capecitabine requires prospective validation.