Predicting the efficacy of chemoradiotherapy for locally advanced human papilloma virus-related oropharyngeal squamous cell carcinoma using one course of TPF chemotherapy

Purpose The standard induction chemotherapy for head and neck cancer is TPF [cisplatin (CDDP), docetaxel (DOC), and 5-fluorouracil (5-FU)]. We assessed whether one course of TPF could predict the efficacy of chemoradiotherapy for human papilloma virus (HPV)-related oropharyngeal squamous cell carcinoma. Methods We retrospectively reviewed 51 patients with stage III-IV HPV-related oropharyngeal squamous cell carcinoma who received one course of TPF with CDDP 60 mg/m(2), DOC 60 mg/m(2), and 5-FU 600 mg/m(2). We recommended chemoradiotherapy for patients with complete or partial response (CR/PR), and surgery for those with stable or progressive disease (SD/PD). The endpoints were TPF-related adverse events and efficacy, chemoradiotherapy efficacy, and 2-year survival. Results Neutropenia was the most common grade >= 3 adverse event (88%). No grade 5 adverse events occurred. TPF achieved CR in 4% of patients (2/51), PR in 73% (37/51), SD in 20% (10/51), and PD in 4% (2/51). Concurrent cetuximab and radiotherapy (bio-radiotherapy, BRT) were administered to 61% of patients (31/51), concurrent CDDP and radiotherapy (CDDP-RT) to 16% (8/51), RT alone to 2% (1/51), and surgery was performed for 22% (11/51). CR was achieved in 85% of the chemoradiotherapy group, and the rate tended to increase with TPF efficacy. CR was achieved in 84% (26/31) of patients receiving BRT, 88% (7/8) receiving CDDP-RT, and 100% (1/1) receiving RT. The 2-year survival rates were 92% overall, and 97% and 79% in the chemoradiotherapy and surgery groups, respectively. Conclusions When facing difficulty in deciding between chemoradiotherapy and surgery, one course of TPF may be an effective option.

Automated summary

One course of TPF chemotherapy can predict the efficacy of chemoradiotherapy in HPV-related oropharyngeal squamous cell carcinoma, with better outcomes for patients with complete or partial response to TPF. The efficacy of TPF is associated with the response rate of chemoradiotherapy, leading to high 2-year survival rates in the treatment group.