Docetaxel, Cisplatin and 5-Fluorouracil in Patients with Refractory, Recurrent, or Metastatic Squamous Cell Carcinoma of the Head and Neck

Abstract

Background: This study retrospectively investigated the effects of one chemotherapy regimen-docetaxel, cisplatin, and 5-fluorouracil- in the treatment of patients with refractory, recurrent, or metastatic squamous cell carcinoma of the head and neck. Patients and Methods: We reviewed the medical history of 25 patients diagnosed with refractory, recurrent, or metastatic squamous cell carcinoma of the head and neck. Eightteen of the 25 patients had tumor resection, while all 25 patients received concurrent chemoradiotherapy with cisplatin and 5-FU as the primary therapy. For the 25 patients who had recurrent tumors that were unable to undergo further surgery or local radiotherapy, we applied a regimen consisting of docetaxel, cisplatin, and 5-fluorouracil (TPF) as palliative chemotherapy. The dosage was: docetaxel 50 mg/m^2 and cisplatin 50 mg/m^2 on day 1, followed by 5-fluorouracil 500 mg/m^2 per day for 3-5 days. This regimen was repeated every 28 days. Results: Twenty-five patients received a total 78 cycles of chemotherapy with the regimen docetaxel, cisplatin, and 5-fluorouracil. Each patient was given at least three cycles of chemotherapy on average. The main manifestation of toxicity was marrow suppression. Fifty-two percent of patients had Grade 3 or Grade 4 neutropenia during treatment. One patient died from septicemia associated with severe neutropenia. No complete response was achieved and 40% of patients had partial response, while 32% of patients obtained a stable disease condition. Median overall survival time was 38 weeks. Twenty-eight percent of patients survived for more than one year. Conclusions: As a palliative chemotherapy regimen, the dosing schedule of docetaxel, cisplatin, and 5-fluorouracil used in this study demonstrated its effectiveness and was well tolerated in patients with refractory, recurrent, or metastatic squamous cell carcinoma of the head and neck.