Predicting the efficacy of chemoradiotherapy for locally advanced human papilloma virus-related oropharyngeal squamous cell carcinoma using one course of TPF chemotherapy.

Autor: Kondo, Takahito, Tsukahara, Kiyoaki, Okamoto, Isaku, Sato, Hiroki, Okada, Takuro, Maruyama, Ryo, Hihara, Kosuke, Ito, Tatsuya, Takeda, Atsuo, Kikawada, Naiue, Aihara, Yusuke, Ogawa, Yasuo
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Zdroj: European Archives of Oto-Rhino-Laryngology; Sep2021, Vol. 278 Issue 9, p3497-3506, 10p
Abstrakt: Purpose: The standard induction chemotherapy for head and neck cancer is TPF [cisplatin (CDDP), docetaxel (DOC), and 5-fluorouracil (5-FU)]. We assessed whether one course of TPF could predict the efficacy of chemoradiotherapy for human papilloma virus (HPV)-related oropharyngeal squamous cell carcinoma. Methods: We retrospectively reviewed 51 patients with stage III–IV HPV-related oropharyngeal squamous cell carcinoma who received one course of TPF with CDDP 60 mg/m2, DOC 60 mg/m2, and 5-FU 600 mg/m2. We recommended chemoradiotherapy for patients with complete or partial response (CR/PR), and surgery for those with stable or progressive disease (SD/PD). The endpoints were TPF-related adverse events and efficacy, chemoradiotherapy efficacy, and 2-year survival. Results: Neutropenia was the most common grade ≥ 3 adverse event (88%). No grade 5 adverse events occurred. TPF achieved CR in 4% of patients (2/51), PR in 73% (37/51), SD in 20% (10/51), and PD in 4% (2/51). Concurrent cetuximab and radiotherapy (bio-radiotherapy, BRT) were administered to 61% of patients (31/51), concurrent CDDP and radiotherapy (CDDP-RT) to 16% (8/51), RT alone to 2% (1/51), and surgery was performed for 22% (11/51). CR was achieved in 85% of the chemoradiotherapy group, and the rate tended to increase with TPF efficacy. CR was achieved in 84% (26/31) of patients receiving BRT, 88% (7/8) receiving CDDP-RT, and 100% (1/1) receiving RT. The 2-year survival rates were 92% overall, and 97% and 79% in the chemoradiotherapy and surgery groups, respectively. Conclusions: When facing difficulty in deciding between chemoradiotherapy and surgery, one course of TPF may be an effective option. [ABSTRACT FROM AUTHOR]
Databáze: Complementary Index
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