Role of induction chemotherapy with taxane, cisplatin and 5-fluorouracil in larynx preservation for locally advanced resectable hypopharyngeal cancer: a prospective cohort study

Introduction:

Induction chemotherapy as a larynx preservation treatment strategy is available in advanced hypopharyngeal cancer for over 20 years. We conducted a prospective study to evaluate this protocol with taxene, cisplatin and 5- fluorouracil in China.

Methods:

Patients (aged ≥18 years) with untreated, locally advanced hypopharyngeal carcinoma were enrolled from 3 academic medical centers in China. The clinical tumor response was assessed after two cycles of chemotherapy, and patients with a response received a third cycle. Salvage surgery was performed when patients relapsed after chemotherapy and radiation. This study is registered with the Chinese Clinical Trial Registry, number ChiCTR-OOC-17010546.

Results:

From January 2012 to December 2015, 176 patients with a median age of 58 years (range, 39 – 80 years) entered the trial. One hundred seven patients (63%) with complete or partial responses to induction chemotherapy received radiotherapy, and 63 patients (37%) with less than a partial response received surgery. The estimated three-year overall survival rate was 44.5% (95% CI 39.5 to 49.5%). There was no difference between responders (44.8%) and non-responders (43.9%) (p = 0.237), however patients who showed a partial response after induction chemotherapy had a significant decrease in survival (32.4%) (p < 0.001).

Conclusions:

In patients with hypopharyngeal cancer, induction chemotherapy with TPF regimen followed by radiotherapy for larynx preservation, which is feasible and safe, may be suitable for complete responders but not partial responders.

Publication History

Publication Date:
18 April 2018 (online)