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Three-drug combination induction chemotherapy improved larynx preservation rate by 12.8%
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Patients with locally advanced larynx and hypopharynx cancer had improved organ preservation when docetaxel was added to the traditional combination of induction chemotherapy with cisplatin and 5-FU, according to results from a French Head and Neck Oncology Radiotherapy Group study.
Researchers randomly assigned 213 patients with cancer that required total laryngectomy to induction chemotherapy with docetaxel, cisplatin and 5-FU or to cisplatin and 5-FU alone. Median follow-up was 36 months. Those who responded to chemotherapy were assigned to radiation treatment. Those who did not respond underwent surgery.
The three-year larynx preservation rate for patients in the experimental group was 70.3% compared with 57.5% in the control group (P=.03). The overall response rate in the experimental group was 80.0% vs. 59.2% for patients assigned cisplatin/5-FU.
Patients in the experimental group had more grade-2 alopecia (19.4% vs. 2.0%), grade-4 neutropenia (31.5% vs. 17.6%) and more grade-3 infections. Patients assigned to cisplatin/5-FU experienced more grade-3/4 stomatitis (7.8% vs. 4.6%) and thrombocytopenia (7.8% vs. 1.8%), and more grade-4 elevated creatinine levels (2.0% vs. 0%).
Calais G. J Natl Cancer Inst. 2009;101:498-506.