Weekly Low-Dose Docetaxel-Based Chemoradiotherapy for Locally Advanced Oropharyngeal or Hypopharyngeal Carcinoma: A Retrospective, Single-Institution Study

Journal Article · Mon Feb 01 04:00:00 EST 2010 · International Journal of Radiation Oncology, Biology and Physics

DOI:https://doi.org/10.1016/j.ijrobp.2009.01.056· OSTI ID:21372055

Fukada, Junichi ^[1]; Shigematsu, Naoyuki ^[1]; Takeda, Atsuya ^[2]; Ohashi, Toshio ^[1]; Tomita, Toshiki ^[3]; Shiotani, Akihiro ^[4]; Kunieda, Etsuo; Kawaguchi, Osamu ^[1]; Fujii, Masato ^[3]; Kubo, Atsushi ^[1]

---

1. Department of Radiology, Keio University, School of Medicine, Tokyo (Japan)
2. Department of Radiology, Ofuna Chuo Hospital, Kanagawa (Japan)
3. Department of Otolaryngology, Keio University, School of Medicine, Tokyo (Japan)
4. Department of Otolaryngology-Head and Neck Surgery, National Defense Medical College, Saitama (Japan)

Purpose: To retrospectively assess the efficacy, toxicity, and prognostic factors of weekly low-dose docetaxel-based chemoradiotherapy for Stage III/IV oropharyngeal or hypopharyngeal carcinoma. Methods and Materials: Between 2001 and 2005, 72 consecutive patients with locally advanced oropharyngeal or hypopharyngeal carcinoma were treated with concurrent chemoradiotherapy (CCR; radiation at 60 Gy plus weekly docetaxel [10 mg/m{sup 2}]). Thirty of these patients also received neoadjuvant chemotherapy (NAC; docetaxel, cisplatin, and 5-fluorouracil) before concurrent chemoradiotherapy. Survival was calculated according to the Kaplan-Meier method. The prognostic factors were evaluated by univariate and multivariate analyses. Results: The median follow-up was 33 months, with overall survival, disease-free survival, and locoregional control rates at 3 years of 59%, 45%, and 52%, respectively. Thirty-six patients (50%) experienced more than one Grade 3 to 4 acute toxicity. Grade 3 mucositis occurred in 32 patients (44%), Grade 4 laryngeal edema in 1 (1%). Grade >=3 severe hematologic toxicity was observed in only 2 patients (3%). Grade 3 dysphagia occurred as a late complication in 2 patients (3%). Multivariate analyses identified age, T stage, hemoglobin level, and completion of weekly docetaxel, but not NAC, as significant factors determining disease-free survival. Conclusions: Docetaxel is an active agent used in both concurrent and sequential chemoradiotherapy regimens. Mucositis was the major acute toxicity, but this was well tolerated in most subjects. Anemia was the most significant prognostic factor determining survival. Further studies are warranted to investigate the optimal protocol for integrating docetaxel into first-line chemoradiotherapy regimens, as well as the potential additive impact of NAC.

• OSTI ID: 21372055
• Journal Information: International Journal of Radiation Oncology, Biology and Physics, Journal Name: International Journal of Radiation Oncology, Biology and Physics Journal Issue: 2 Vol. 76; ISSN IOBPD3; ISSN 0360-3016
• Country of Publication: United States
• Language: English

Related Subjects

62 RADIOLOGY AND NUCLEAR MEDICINE
ANEMIAS
ANTINEOPLASTIC DRUGS
AZINES
BODY
CARCINOMAS
CHEMOTHERAPY
COMBINED THERAPY
DIGESTIVE SYSTEM
DISEASES
DRUGS
HEMIC DISEASES
HETEROCYCLIC COMPOUNDS
HYDROXY COMPOUNDS
MATHEMATICS
MEDICINE
MULTIVARIATE ANALYSIS
NEOPLASMS
NUCLEAR MEDICINE
ORGANIC COMPOUNDS
ORGANIC NITROGEN COMPOUNDS
ORGANS
PHARYNX
PYRIMIDINES
RADIOLOGY
RADIOTHERAPY
RESPIRATORY SYSTEM
STATISTICS
SURVIVAL CURVES
SYMPTOMS
THERAPY
TOXICITY
URACILS