Chemotherapy with Modified Docetaxel, Cisplatin, and 5-Fluorouracil in Patients with Metastatic Head and Neck Cancer

• Published in: Advances in therapy 2012, Vol.29 (1), p.71-77
• Main Authors: Lin, Jen-Tsun, Lai, Guam-Min, Chang, Tung-Hao, Liu, Mu-Tai, Bi, Chu-Ping, Wang, Jer-Wei, Chen, Mu-Kuan
• Format: Article
• Language: English
• Subjects: Adult; Aged; Antineoplastic Combined Chemotherapy Protocols - adverse effects; Antineoplastic Combined Chemotherapy Protocols - therapeutic use; Cardiology; Cisplatin - administration & dosage; Disease Progression; Endocrinology; Fluorouracil - administration & dosage; Head and Neck Neoplasms - drug therapy; Head and Neck Neoplasms - ethnology; Humans; Internal Medicine; Male; Medicine; Medicine & Public Health; Middle Aged; Neoplasm Metastasis - drug therapy; Neoplasms, Squamous Cell - drug therapy; Oncology; Original Research; Palliative Care; Pharmacology/Toxicology; Remission Induction; Retrospective Studies; Rheumatology; Survival Rate; Taxoids - administration & dosage
• ISSN: 0741-238X; 1865-8652
• DOI: 10.1007/s12325-011-0085-2

Introduction This retrospective study evaluates the efficacy of palliative chemotherapy with a modified docetaxel, cisplatin, 5-fluorouracil (5-FU; “TPF” regimen) regimen (mTPF; reduced doses of docetaxel, cisplatin, and 5-FU with reduction of intravenous 5-FU from 4 days to 2 days) in Asian patients with recurrent and metastatic squamous cell carcinoma of head and neck (HNSCC) after surgery and adjuvant chemoradiation. Methods The mTPF regimen was used in this study. Fifty-five patients (from January 2007 to October 2009) received docetaxel on day 1, followed by cisplatin and 5-FU administered continuous infusion on day 2 for another 48 hours every 3 weeks for three to six cycles. Results The disease control rate was 81%. The overall response rate was 56%. Five patients achieved complete remission; 26 patients had partial remission; 14 patients had stable disease. Ten patients had disease progression. The metastatic sites that responded well to mTPF regimen (either complete or partial remission) were: neck lymph node, lung, liver, and skin. The median follow-up was 15 months (range 1–28 months). The median overall survival was 10 months (range 2–28 months). The common nonhematological toxicity was alopecia and the most common hematological adverse event was neutropenia. Thirty-one patients (56%) had grade 3–4 neutropenia. Conclusion The mTPF chemotherapy regimen is efficacious for the palliative treatment of recurrent and metastatic HNSCC in Asian patients.