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

Woo Kyun Bae, Jun Eul Hwang, Hyun Jeong Shim, Sang Hee Cho, Ki Hyeong Lee, Hye Suk Han, Eun-Kee Song, Hwan Jung Yun, In Sung Cho, Joon Kyoo Lee, Sang-Chul Lim, Woong-Ki Chung, Ik-Joo Chung, Woo Kyun Bae, Jun Eul Hwang, Hyun Jeong Shim, Sang Hee Cho, Ki Hyeong Lee, Hye Suk Han, Eun-Kee Song, Hwan Jung Yun, In Sung Cho, Joon Kyoo Lee, Sang-Chul Lim, Woong-Ki Chung, Ik-Joo Chung

Abstract

Background: 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).

Methods: 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/m(2) docetaxel on day 1 and 8, 60 mg/m(2) cisplatin on day 1, and 70 mg/m(2) S-1 on days 1 to 14. The regimen was repeated every 21 days. After three courses of induction chemotherapy, patients received concurrent chemoradiotherapy.

Results: 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.

Conclusions: Weekly TPS is a promising regimen that is well-tolerated, causes minimal myelosuppression and is effective as an outpatient regimen for locally advanced HNSCC.

Trial registration: ClinicalTrials.gov: NCT01645748.

Figures

Figure 1
Figure 1
Kaplan-Meier estimates of progression-free survival (PFS) and overall survival (OS) for all patients. The 2-year PFS & OS rate was 79.3% (95% CI 58.4 ~ 99.6%) and 73.2% (95% CI 52.4 ~ 93.6%).

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