4.5 Article

Short-term outcomes of induction chemotherapy with docetaxel, cisplatin, and fluorouracil (TPF) in locally advanced nasopharyngeal carcinoma

Journal

INVESTIGATIONAL NEW DRUGS
Volume 39, Issue 2, Pages 564-570

Publisher

SPRINGER
DOI: 10.1007/s10637-020-00999-y

Keywords

Nasopharyngeal carcinoma; Induction chemotherapy; Chemoradiotherapy; Docetaxel; Cisplatin; Fluorouracil

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This study aimed to evaluate the short-term outcomes of locally advanced nasopharyngeal carcinoma patients treated with induction chemotherapy (IC) using TPF followed by chemoradiotherapy (CRT) with cisplatin. The results showed promising short-term effectiveness of IC-TPF followed by CRT, but also highlighted the high rates of hematological toxicity. Long-term follow-up is needed to further assess the clinical outcomes and late-phase toxicity of this therapeutic approach.
There is an unmet need for improving survival outcomes of locally advanced nasopharyngeal carcinoma, for example, T4/ N3 stage disease. To this end, we administered induction chemotherapy (IC) with TPF (docetaxel, cisplatin, and fluorouracil) because this stage of disease is associated with a high risk of recurrence and is difficult to control with standard treatments, such as chemoradiotherapy (CRT) alone or CRT followed by adjuvant chemotherapy. The aim of this retrospective single-center study was to clarify the short-term outcomes of locally far-advanced nasopharyngeal carcinoma patients treated with IC-TPF, followed by CRT with cisplatin. Data from 11 patients were extracted from our database, indicating that the overall response rate to IC-TPF, clinical complete response rate after CRT, 1-year progression-free survival, and 1-year overall survival were 73%, 91%, 68%, and 89%, respectively. Hematological toxicity was the most common adverse event reported during IC-TPF with 64% of patients suffering grade 3 or 4 neutropenia, 55% grade 3 or 4 leucopenia and 9% febrile neutropenia. Despite the small number of patients, these data are important because there is a limited number of studies investigating IC-TPF followed by CRT in Japanese patients. This pilot study provides some indication of the short-term effectiveness and toxicity of this therapeutic approach, which may be superior to standard treatments. Long-term follow-up is warranted to assess the effectiveness of IC-TPF in terms of clinical outcome and late-phase toxicity.

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