gms | German Medical Science

Squamous cell carcinoma of the head and neck (SCCHN) presents at a locally advanced (LA) stage in many patients. Chemotherapy, which is one fundamental therapy mode for local disease control of inoperable disease or if organ preservation is desired, has become one important factor of first line treatment regimes either during or prior to radiotherapy (RT).

Patients with locoregionally advanced inoperable, recurrent or metastatic disease still have a poor prognosis, which enforces the need for new treatment approaches and new drug therapies, adjusted to the different settings of the disease.

One innovative progress for this collective of patients with locally advanced tumor was the implementation of Docetaxel in chemotherapeutic regimes in optimal combination with concurrent chemoradiotherapy or in neoadjuvant setting of induction phase treatment.

Docetaxel combined with the conventional chemotherapy regimen, containing Cisplatin and 5-Fluorouracil (TPF), is now acknowledged as being the gold standard of induction treatment.

Various studies suggest survival advantage due to the induction chemotherapy (ICT) followed by chemoradiotherapy, which is known as sequential therapy, over chemoradiotherapy alone.

In contrast to prevailing studies we applicated Docetaxel, Carboplatin and 5-FU within the framework of induction chemotherapy instead of conventional use of Cisplatin for five patients with locoregionally advanced HNSCC. The clinical progress was evaluated through cross section imaging (computertomography/MRI) prior and after applicated ICT and classified after the RECIST criterias. Due to a very small collective of patient and the application of Carboplatin instead of Cisplatin in this study, it was not able to document the published results of the effectiveness of ICT (TPF) concerning to survival advantage in patient with locoregionally advanced head and neck tumors. Further studies with an extended collective of patients are neccessary.