Induction chemotherapy in nonlaryngeal human papilloma virus-negative high-risk head and neck cancer: a real-world experience.
Adult
Aged
Antineoplastic Combined Chemotherapy Protocols
/ adverse effects
Cisplatin
/ administration & dosage
Docetaxel
/ administration & dosage
Female
Fluorouracil
/ administration & dosage
Head and Neck Neoplasms
/ drug therapy
Humans
Induction Chemotherapy
/ adverse effects
Laryngeal Neoplasms
Male
Middle Aged
Papillomavirus Infections
Progression-Free Survival
Retrospective Studies
Squamous Cell Carcinoma of Head and Neck
/ drug therapy
Treatment Outcome
Journal
Anti-cancer drugs
ISSN: 1473-5741
Titre abrégé: Anticancer Drugs
Pays: England
ID NLM: 9100823
Informations de publication
Date de publication:
11 2020
11 2020
Historique:
pubmed:
16
9
2020
medline:
1
9
2021
entrez:
15
9
2020
Statut:
ppublish
Résumé
The role of induction chemotherapy in the multidisciplinary treatment of locally advanced, nonlaryngeal high-risk human papilloma virus (HPV)-negative head and neck squamous cells carcinoma (HNSCC) is uncertain in terms of overall survival (OS). The primary objective of this study was to identify possible predictive factors of survival and outcome in patients with HNSCC who were treated with induction chemotherapy. Fifty-nine patients with stage IVa/b HPV-negative non-laryngeal HNSCC (mostly originating from the oral cavity) who underwent induction chemotherapy at Policlinico Umberto I were reviewed. Treatment outcomes in term of objective response rate (ORR), progression-free survival (PFS), OS and toxicities were analyzed. A significant association between nodal status, ORR, ongoing smoking use, toxicities and OS was demonstrated. ORR (obtained in 61% of patients) was associated with a reduction in mortality of 80% (P< 0.0001). Early discontinuation after just one cycle of induction chemotherapy was associated to a significantly shorter OS. In oral cavity radical surgery with negative margins was obtained in 15/16 patients. In 42% of patients G3-G4 toxicity occurred. Toxicity requiring hospitalization occurred in 42% and 21% of patients with oropharyngeal and oral cavity carcinoma, respectively. Five patients died of treatment-related causes. No treatment-related mortality occurred in oral cavity patients. G5 toxicities were different according to the sub-sites of disease (P = 0.05). Induction chemotherapy in non-laryngeal high-risk HNSCC is an active strategy, most importantly in oral cavity cancer, even though burdened with a high (G ≥ 3) toxicity and early discontinuation rate. These data will however need to be confirmed in further and larger studies.
Identifiants
pubmed: 32932276
doi: 10.1097/CAD.0000000000000977
pii: 00001813-202011000-00011
doi:
Substances chimiques
Docetaxel
15H5577CQD
Cisplatin
Q20Q21Q62J
Fluorouracil
U3P01618RT
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
1074-1083Références
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