Abstract
Objective:To evaluate the response rate of Cisplatin plus Docetaxel in the treatment of locally advanced head and neck squamous cell carcinomas (HNSCC) at a tertiary care hospital in Karachi, Pakistan. Materials and Methods:It was a longitudinal study, conducted at the Department of Medical Oncology, Jinnah Postgraduate Medical Center, Karachi, Pakistan from December 2018 to June 2019. One hundred patients of age 14-66 years of age of either gender with histologically proven Squamous Cell Carcinoma of Head and Neck, Stage III and IV (locally advanced) with no distant metastases were included in the study. Patients who were declared unresectable by the otolaryngologist and those with delayed appointment for radiation were given 3 cycles of Induction Chemotherapy with Cisplatin and Docetaxel, both at a dose of 75mg/m2 3 weekly. After 3 cycles, CT scan was repeated to assess the clinical response. Those patients who had partial or complete response as per RECIST criteria were re-assessed by the otolaryngologist and were planned for surgery if disease became resectable while other patients were referred for Concurrent Chemo-Radiation Therapy (CCRT). SPSS version 23 was used to analyze data. Results:The partial response was achieved in majority of the patients after Induction Chemotherapy with Docetaxel and Cisplatin (62%) with a complete response in 12 %. However, 22% showed progression of the disease, and 4% showed stable disease. The most frequent side effects observed were diarrhea (62%) and neutropenia (57%). Conclusion:Induction chemotherapy with Cisplatin and Docetaxel is a promising regimen with good response and favorable toxicity profile and can be considered as a potentially effective outpatient regimen for locally advanced squamous cell carcinoma of head and neck.
Highlights
Around the globe head and neck carcinomas (HNCs) is the 6th most common cancer with the incidence of 650,000 cases and 330,000 cases of mortality yearly (Bray et al, 2018)
The patients of age 14-66 years of either gender with histological proven squamous cell carcinoma of head and neck of locally advanced stage III and IV with no distant metastases were included in the study
In the current study we have evaluated the role of cisplatin plus docetaxel in the treatment of locally advanced HNCs
Summary
Around the globe head and neck carcinomas (HNCs) is the 6th most common cancer with the incidence of 650,000 cases and 330,000 cases of mortality yearly (Bray et al, 2018). For patients with locally advanced squamous cell carcinoma of the head and neck (HNSCC), rapid advancements regarding the choice of induction chemotherapy regimen have been made. In the clinical trials of phase I and II docetaxel plus cisplatin or fluorouracil (5-FU) for the treatment of locally advanced squamous-cell HNCs, showed prolonged survival and high clinical and pathological response rates (Colevas et al, 2000; Tubiana-Mathieu et al, 2000). Whereas in the clinical trials of docetaxel with cisplatin, the overall response rates were reported as 33-76% and appeared to be more efficacious combination (Kienzer et al, 1998; Schoffski et al, 1999; Specht et al, 2000; Glisson et al, 2002). The aim of our study was to evaluate the response rate of cisplatin plus docetaxel as Induction chemotherapy in the treatment of locally advanced HNCs (squamous cell types). This study will help in improving the functional outcomes and cure rates and integration of cisplatin with docetaxel as the potential agents of chemotherapy this approach might be helpful in both resectable and unresectable HNCs patients
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