© 2005-2012 American Society of Clinical Oncology (ASCO). All rights reserved worldwide.
Findings from a clinical trial show that induction chemotherapy (chemotherapy that is given before other treatment) with docetaxel (Taxotere), cisplatin (Platinol), and fluorouracil (5-FU) reduces the risk of death by 30% for patients with advanced head and neck cancer. Patients were then given weekly chemotherapy together with radiation therapy (chemoradiotherapy) to complete their treatment. This treatment program is referred to as sequential therapy.
This study included 538 patients with squamous cell cancer of the larynx (voice box), pharynx (back of the throat), and oral cavity (mouth, tongue, and jaw). Half of the patients received induction chemotherapy with a three-drug combination of cisplatin, 5-FU, and docetaxel, and the other half received the standard two-drug combination of cisplatin and 5-FU as a comparison or control. After the first therapy, the patients were treated weekly with carboplatin (Paraplatin), radiation therapy, and in some cases, surgery.
On average, the patients were followed for nearly 42 months. At three years, 62% of the patients receiving the three-drug regimen were alive, compared with 48% of the patients in the control group. The side effects were comparable between the two groups and were primarily related to radiation therapy. Side effects during chemotherapy were temporary and included mouth sores, nausea, vomiting, and low blood cell counts.
"This is the first study to look at survival and use this combination of drugs as induction therapy before chemoradiotherapy," said Marshall R. Posner, MD, Associate Professor, Harvard Medical School, Medical Director of the Head and Neck Oncology Program at Dana-Farber Cancer Institute in Boston, and lead author of the study.
What This Means For Patients
Treating patients with advanced head and neck cancer with docetaxel, cisplatin, and 5-FU first, followed by chemoradiotherapy, helps them live longer. However, it is not yet known whether this treatment approach is better than chemoradiotherapy alone, which is the standard of care at many hospitals. Patients are encouraged to talk with their doctors about the best way to treat advanced head and neck cancer.