Induction Chemotherapy with Docetaxel and Cisplatin Followed by Concomitant Chemoradiotherapy in Patients with Inoperable Non-nasopharyngeal Carcinoma of the Head and Neck

Background: Induction chemotherapy (IC) followed by concomitant chemoradiotherapy (CCRT) has the potential of being an ideal multi-modality approach for improving the prognosis of patients with squamous cell carcinoma of the head and neck (SSCHN). Patients and Methods: Thirty-four patients with locally advanced SCCHN were treated with 3 cycles of IC, consisting of docetaxel 75 mg/m(2) and cisplatin 75 mg/m(2) even 3 weeks, followed 3-4 weeks later by definitive radiotherapy (70 Gy) and concomitant weekly cisplatin 40 mg/m(2). Results: After a median follow-up of 27.7 months, 6-month progression-free survival (PFS), the primary study end-point, was 84%. The median PFS was 16.4 months and median overall survival 24.4 months. The majority of the patients completed 3 cycles of IC with mild to moderate toxicity. Anemia, nausea/vomiting and mucositis were the prominent toxicities during CCRT Retrospective analysis of a panel of biomarkers suggested that excision repair cross-complementation group 1 (ERCC1) protein expression was associated with shorter PFS. Conclusion: IC followed by CCRT as administered in the present study, is a feasible and well-tolerated therapeutic approach. However, its real impact on the prognosis of SCCHN patients has to be demonstrated in a randomized study comparing this treatment to CCRT alone.