Abstract
Background Head and neck squamous cell carcinoma (HNSCC) in Taiwan is associated with betel-nut chewing. Indcution chemotherapy with TPF is standard after theTAX324 trial. But the side effects of TPF regimen is of concern in Asia. 12% neutropenic fever and 83% grade ¾ neutropenia were found in the TAX 324 study. We hypothesise the APF regimen may avoid taxotere-related toxicity and retain treatment efficacy. This retrospective study was aimed at evaluating the efficacy of APF for this population. Methods Patients with locally HNSCC were retrospectively reviewed in a university hospital in Taiwan from Oct 2014 to Dec 2015. Patients receiving induction chemotherapy wtih APF for curative intent were recorded for analysis. The history of alcohol drinking, betel nut chewing, and cigarette smoking were coded according to medical records. The clinical response described in medical records and image reports were retrieved. Results Twenty-seven HNSCC patients receiving induction chemotherapy with APF for curative intent were recorded. In this population, 26 (96%) were male, 9(33.3%) were oral cavity HNSCC, 6 (22.2%) were oropharynx HNSCC, 11 (40.7%) were hypopharynx HNSCC. 18(66.7%) had history of betel-nut chewing, 24 (88.9%) had history of smoking, 20 (74.1%) had history of alcohol drinking. 24 (88.9%) were clinical stage III, IVa and IVb. The response rate after indcution chemotherapy with APF(1~3 cycles, median 2 cycles) were 92.6%. 4 (14.8%) patients were in complete remission, 3 (11.1%) patients were in pathologic complete remission. 4 (14.8%) patients had grade 3/ 4 neutropenia, 1 (3.7%) patient had neutropenic fever, 1 (3.7%) had grade 3 acute kidney injury. No tumor bleeding, nor treatment related death was recorded. Conclusions The effect of induction chemotherapy with APF for betel-nut-chewing- associated HNSCC is comparative to other studies with TPF regimen. And the side effect profile of APF was acceptable. Further confirmatory studies of induction chemtherapy with APF for this population are mandatory. Legal entity responsible for the study Huai-Cheng Huang Funding National Taiwan University Hospital Disclosure All authors have declared no conflicts of interest.
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