Docetaxel, cisplatin and 5-fluorouracil-based induction chemotherapy followed by intensity-modulated radiotherapy concurrent with cisplatin in locally advanced EBV-related nasopharyngeal cancer

P. Bossi, E. Orlandi, C. Bergamini, L. D. Locati, R. Granata, A. Mirabile, D. Parolini Franceschini, C. Fallai, P. Olmi, P. Quattrone, P. Potepan, A. Gloghini, R. Miceli, F. Mattana, G. Scaramellini, L. Licitra

Research output: Contribution to journalArticle

Abstract

Background: This monocentric study evaluates the activity and tolerability of docetaxel (Taxotere), cisplatin and 5-fluorouracil (5-FU) (TPF) induction chemotherapy followed by intensity-modulated radiotherapy (IMRT) concurrent with high-dose cisplatin in Epstein-Barr virus -related locally advanced undifferentiated nasopharyngeal cancer. Patients and methods: We retrospectively reviewed the records of patients who received induction docetaxel 75 mg/m2 and cisplatin 75 mg/m2 on day 1, and 5-FU 750 mg/m2/day (96-h continuous infusion). Following induction, patients received full doses of IMRT concurrently with cisplatin 100 mg/m2 every 21 days for three cycles. Results: Thirty patients received three TPF cycles (median). Induction was well tolerated; the main toxicity was neutropenia (33%, grade 3-4). During chemoradiotherapy, neutropenia (40%) and mucositis (43%) were the most frequent grade 3-4 adverse events. Mean dose of IMRT was 68.8 Gy. Worst late toxicity was xerostomia. Complete response rate was 93%. At 35 months, two patients had locoregional recurrence, three had distant metastases, and one had both. Three-year progression-free survival and overall survival were 79% [95% confidence interval (CI) 64% to 94%] and 87% (95% CI 74%- to 100%), respectively. Conclusions: In this high-stage nonendemic cancer population, TPF followed by high-dose cisplatin IMRT was promising; this treatment approach deserves evaluation in randomized trials.

Original languageEnglish
Pages (from-to)2495-2500
Number of pages6
JournalAnnals of Oncology
Volume22
Issue number11
DOIs
Publication statusPublished - Nov 2011

Keywords

  • Cisplatin
  • Docetaxel
  • Induction chemotherapy
  • Intensity-modulated radiotherapy
  • Nasopharyngeal carcinoma

ASJC Scopus subject areas

  • Oncology
  • Hematology

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