Multicenter phase II study of weekly docetaxel, cisplatin, and S-1 (TPS) induction chemotherapy for locally advanced squamous cell cancer of the head and neck
1 Department of Hematology-Oncology, Chonnam National University, Gwangju, Korea
2 Department of Hematology-Oncology, Chungbuk National University, Cheongju, Korea
3 Department of Hematology-Oncology, Chonbuk National University, Jeonju, Korea
4 Department of Hematology-Oncology, Chungnam National University, Daejeon, Korea
5 Eulji University Hospital, Daejeon, Korea
6 Department of Otorhinolaryngology-Head and Neck Surgery, Chonnam National University, Gwangju, Korea
7 Department of Radiation Oncology, Chonnam National University, Gwangju, Korea
8 Department of Internal Medicine, Chonnam National University Hwasun Hospital, 160 Ilsim-ri, Hwasun-eup, Hwasun-gun, 519-809, Korea
BMC Cancer 2013, 13:102 doi:10.1186/1471-2407-13-102Published: 6 March 2013
The purpose of this study was to evaluate the efficacy and tolerability of weekly docetaxel, cisplatin, and S-1 (weekly TPS) as induction chemotherapy for patients with locally advanced head and neck squamous cell carcinoma (HNSCC).
A total of 35 patients with previously untreated, locally advanced HNSCC were enrolled. Seven patients (20%) were diagnosed with stage III HNSCC and 28 patients (80%) were diagnosed with stage IV. Induction treatment included 30 mg/m2 docetaxel on day 1 and 8, 60 mg/m2 cisplatin on day 1, and 70 mg/m2 S-1 on days 1 to 14. The regimen was repeated every 21 days. After three courses of induction chemotherapy, patients received concurrent chemoradiotherapy.
Among the 35 patients, 30 (85.7%) completed induction chemotherapy. The response to induction chemotherapy was as follows: nine patients (25.7%) achieved a complete response (CR) and the overall response rate (ORR) was 85.7%. Grades 3–4 toxicity during induction therapy included neutropenia (28.5%), neutropenic fever (8.5%), and diarrhea (17.1%). After completion of concurrent chemoradiotherapy, the CR rate was 62.8% and the partial response (PR) was 22.8%. Estimates of progression-free and overall survival at 2 years were 73.2% and 79.3%, respectively.
Weekly TPS is a promising regimen that is well-tolerated, causes minimal myelosuppression and is effective as an outpatient regimen for locally advanced HNSCC.