Cisplatin and Fluorouracil Alone or with Docetaxel in Head and Neck Cancer

• Published in: The New England journal of medicine Vol. 357; no. 17; pp. 1705 - 1715
• Main Authors: Posner, Marshall R, Hershock, Diane M, Blajman, Cesar R, Mickiewicz, Elizabeth, Winquist, Eric, Gorbounova, Vera, Tjulandin, Sergei, Shin, Dong M, Cullen, Kevin, Ervin, Thomas J, Murphy, Barbara A, Raez, Luis E, Cohen, Roger B, Spaulding, Monica, Tishler, Roy B, Roth, Berta, Viroglio, Rosana del Carmen, Venkatesan, Varagur, Romanov, Ilya, Agarwala, Sanjiv, Harter, K. William, Dugan, Matthew, Cmelak, Anthony, Markoe, Arnold M, Read, Paul W, Steinbrenner, Lynn, Colevas, A. Dimitrios, Norris, Charles M, Haddad, Robert I
• Format: Journal Article
• Language: English
• Published: United States Massachusetts Medical Society 25.10.2007
• Subjects: Adult; Aged; Antineoplastic Combined Chemotherapy Protocols - adverse effects; Antineoplastic Combined Chemotherapy Protocols - therapeutic use; Carcinoma, Squamous Cell - drug therapy; Carcinoma, Squamous Cell - radiotherapy; Carcinoma, Squamous Cell - surgery; Chemotherapy; Cisplatin - administration & dosage; Clinical trials; Combined Modality Therapy; Comparative studies; Disease-Free Survival; Drug therapy; Female; Fluorouracil - administration & dosage; Head & neck cancer; Head and Neck Neoplasms - drug therapy; Head and Neck Neoplasms - radiotherapy; Head and Neck Neoplasms - surgery; Humans; Male; Middle Aged; Radiotherapy - adverse effects; Survival Analysis; Taxoids - administration & dosage; Treatment Outcome
• ISSN: 0028-4793; 1533-4406
• DOI: 10.1056/NEJMoa070956

In this randomized trial, patients who had unresectable stage III or IV squamous-cell head and neck cancer with no distant metastases were assigned to receive induction treatment with docetaxel plus cisplatin and fluorouracil (TPF) or cisplatin and fluorouracil (PF) before receiving chemoradiotherapy. Patients who received TPF induction chemotherapy had significantly longer survival than did patients who received PF induction chemotherapy. Patients who received TPF induction chemotherapy had significantly longer survival than did patients who received cisplatin and fluorouracil induction chemotherapy. Squamous-cell carcinoma of the head and neck accounts for 5% of newly diagnosed cancers in adults in the United States and 8% of cancers worldwide. 1 The disease is potentially curable at an early stage, but most patients present with locally advanced disease. After standard therapy (surgery and irradiation), only 30 to 50% of patients with locally advanced disease live for 3 years, and locoregional recurrences or distant metastases develop in 40 to 60% of them. 2 – 6 Various strategies to improve outcomes by coordinating chemotherapy with surgery and radiotherapy have been tried, but the optimal schedule for integrating chemotherapy into the . . .