Short-term outcomes of induction chemotherapy with docetaxel, cisplatin, and fluorouracil (TPF) in locally advanced nasopharyngeal carcinoma

Invest New Drugs. 2021 Apr;39(2):564-570. doi: 10.1007/s10637-020-00999-y. Epub 2020 Sep 17.

Abstract

There is an unmet need for improving survival outcomes of locally advanced nasopharyngeal carcinoma, for example, T4/ N3 stage disease. To this end, we administered induction chemotherapy (IC) with TPF (docetaxel, cisplatin, and fluorouracil) because this stage of disease is associated with a high risk of recurrence and is difficult to control with standard treatments, such as chemoradiotherapy (CRT) alone or CRT followed by adjuvant chemotherapy. The aim of this retrospective single-center study was to clarify the short-term outcomes of locally far-advanced nasopharyngeal carcinoma patients treated with IC-TPF, followed by CRT with cisplatin. Data from 11 patients were extracted from our database, indicating that the overall response rate to IC-TPF, clinical complete response rate after CRT, 1-year progression-free survival, and 1-year overall survival were 73%, 91%, 68%, and 89%, respectively. Hematological toxicity was the most common adverse event reported during IC-TPF with 64% of patients suffering grade 3 or 4 neutropenia, 55% grade 3 or 4 leucopenia and 9% febrile neutropenia. Despite the small number of patients, these data are important because there is a limited number of studies investigating IC-TPF followed by CRT in Japanese patients. This pilot study provides some indication of the short-term effectiveness and toxicity of this therapeutic approach, which may be superior to standard treatments. Long-term follow-up is warranted to assess the effectiveness of IC-TPF in terms of clinical outcome and late-phase toxicity.

Keywords: Chemoradiotherapy; Cisplatin; Docetaxel; Fluorouracil; Induction chemotherapy; Nasopharyngeal carcinoma.

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Antineoplastic Combined Chemotherapy Protocols / administration & dosage
  • Antineoplastic Combined Chemotherapy Protocols / adverse effects
  • Antineoplastic Combined Chemotherapy Protocols / therapeutic use*
  • Chemoradiotherapy / methods*
  • Cisplatin / therapeutic use
  • Docetaxel / therapeutic use
  • Female
  • Fluorouracil / therapeutic use
  • Humans
  • Induction Chemotherapy / methods*
  • Male
  • Middle Aged
  • Nasopharyngeal Carcinoma / drug therapy
  • Nasopharyngeal Carcinoma / mortality
  • Nasopharyngeal Carcinoma / pathology
  • Nasopharyngeal Carcinoma / therapy*
  • Nasopharyngeal Neoplasms / drug therapy
  • Nasopharyngeal Neoplasms / mortality
  • Nasopharyngeal Neoplasms / pathology
  • Nasopharyngeal Neoplasms / therapy*
  • Neoplasm Staging
  • Pilot Projects
  • Progression-Free Survival
  • Retrospective Studies
  • Young Adult

Substances

  • Docetaxel
  • Cisplatin
  • Fluorouracil