Combination therapy of docetaxel, carboplatin or paclitaxel, carboplatin for patients with metastatic/recurrent carcinoma of the head and neck (SCCHN)

Abstract

5576 Background: The five-year survival for patients with recurrent disease has not been significantly increased in the last years. Despite aggressive initial management of the primary tumor, patients suffer from locoregional recurrence in up to 50% and distant metastasis is seen in about 25% of cases. Materials and Methods: 96 patients with recurrent or metastatic carcinoma of the head and neck received therapy as follows. From August 1996 to May 2000, 52 patients received chemotherapy with paclitaxel 100 mg/m2 in combination with carboplatin AUC2. Between May 2000 and October 2004, 44 patients with recurrent or metastatic disease were treated with docetaxel 35 mg/m2 in combination with carboplatin AUC2. Both chemotherapy regimens were administered weekly for a maximum of six cycles. Results: Most of the patients underwent a combination first line therapy with CT/Surg/RT (48%/47.7%) or CT/RT (36%/23%) before suffering from rec. disease. After recurrence local, regional or distant, we observed 9.6% complete response for the combination-therapy with paclitaxel/carboplatin and 25% with docetaxel/carboplatin, partial response in 38.5% and 34.1% of the patients, yielding an overall response rate of 48.1% with weekly paclitaxel/carboplatin and 59.1% with weekly docetaxel/carboplatin. Stable disease was documented for 25% of the patients treated with paclitaxel/carboplatin and 18.2% after treatment with docetaxel/carboplatin. Median survival was measured after first diagnosis of recurrence or metastatic disease. We observed a median survival of 10.9 month for the group treated with paclitaxel/carboplatin and 37 month for patients treated with docetaxel/carboplatin. Therapy with both treatment-options was well tolerated, all 96 patients received six cycles. Most frequent toxicity was leucopenia (Grade I/II/III: paclitaxel 12%/27%/15%; docetaxel 25%/23%/16%). Conclusions: Chemotherapy for recurrent carcinoma of the head and neck with weekly docetaxel/carboplatin is well tolerated and effective. The toxicitiy profile makes this combination favourable for an outpatient setting. No significant financial relationships to disclose.