Induction Therapy With Cisplatin, 5-Fluorouracil, Leucovorin, and Paclitaxel in Patients With Head and Neck Cancer

Abstract

Background/aim: This study aimed to evaluate the toxicities and response rate of a modified TPF (docetaxel, cisplatin, and 5-fluorouracil) protocol in patients with locally advanced head and neck cancer (ECOG performance status ≤1).

Patients and methods: Induction treatment consisted of cisplatin 25 mg/m²/day as a 90 min infusion for three consecutive days, leucovorin 20 mg/m²/day as a bolus for four consecutive days, 5-fluorouracil (5-FU) 370 mg/m²/day as a bolus for four consecutive days, and paclitaxel 60 mg/m² as a 1-h infusion on Days 1, 8, and 15, repeated every 3-4 weeks (twelve cycles to 6 patients).

Results: The main toxicities were grade 1 neuropathy, mucositis, and fatigue. There were four episodes of severe toxicities (grade ≥3). There was one early death, and 2 patients were discontinued due to hematological toxicity. Other side effects included neutropenia, nausea, diarrhea, and vomiting.

Conclusion: Induction therapy with cisplatin, 5-fluorouracil, leucovorin, and paclitaxel in head and neck cancer is not feasible because of severe toxicity.

Keywords: Head and neck cancer; antineoplastic agents; bone marrow; quality of life; toxicity.