Conventional chemoradiation vs. induction chemotherapy followed by conventional chemoradiation for locally advanced head and neck cancer: A prospective, randomized study

Abstract

The standard-of-care in locally advanced squamous cell carcinoma of the head and neck (LA SCCHN) remains concurrent chemoradiotherapy. The present study compared the disease response and safety profile of induction chemo- therapy followed by concomitant chemoradiotherapy (CRT) vs. CRT alone in patients with LA SCCHN. The present prospec- tive randomized study was conducted between July, 2014 and July, 2015 on 52 patients with SCCHN of the oropharynx, hypopharynx and larynx. Patients were randomly divided into the induction chemotherapy [docetaxel, cisplatin and 5-FU (TPF)] followed by CRT arm (TPF + CRT arm, n=25) or the CRT alone arm (CRT arm, n=27). The disease response, and acute and late toxicities were assessed. At the first follow-up (6 weeks), the overall response rate (ORR) was 82.6% for the TPF + CRT arm and 72% for the CRT arm; the difference was not significant. In addition, no statistically significant differences were observed in the nodal response between the treatment arms. Acute toxicities were significantly higher in the TPF + CRT arm, with respect to mucositis and hemato- logical toxicities. No differences were observed in late-onset toxicities observed following 3 months of radiotherapy. Triple drug-based sequential therapy was tolerable in the popula- tion in the present study and may thus hold promise for the treatment of SCCHN; however, larger prospective studies are required to confirm these results.