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Manuela Velázquez Prieto
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Jaime E. Poquet Jornet
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Margarita Pamplona
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Juan Carlos Juárez Giménez
Volume 16 - Issue 6, November-December 2014
ORIGINAL
CISPLAT IN, DOCETA XEL AND 5 FLUOROURACIL FOLLOWED BY PEGFILGRASTIM SUPPORT AND CISPLAT IN IN HEAD AND NECK CANCER
Gasent Blesa JM, Poquet Jornet JE, Garde J, Giner Bosch V, Soler Tortosa M, Cuesta Grueso C, Fonfria Esparza Mª, Munilla Das A, Olmo Ortega P, Clemente M, San Matías S, Colio JM, Alberola Candel V


Cisplatin plus docetaxel and 5 fluorouracil (DCF) neoadjuvant chemotherapy has proved to increase survival in locally advanced squamous cell carcinoma of the head and neck (SCCHN) when added to chemoradiotherapy, but is associated with increased toxicities. We hypothesized if adding pegfilgastrim, could enhance
the feasibility to administer DCF chemotherapy, improving the response of DCF neoadjuvant chemotherapy.

Method: Patients with stage III–IVM0 SCCHN, Eastern Cooperative Oncology Group performance status of zero to one, were recruited for the present study. Patients received three neoadjuvant cycles of DCF (docetaxel 75 mg/m2 day one, cisplatin 75 mg/m2 day one, 5 fluorouracil 750 mg/m2/day in 96 hours continuous
infusion), with pegfilgastrim support, every three weeks, followed by concomitant chemoradiotherapy with cisplatin 40 mg/m2 weekly and intensity modulatedradiotherapy (IMRT).

Results: A total of 41 patients were included in the present study. After DCF chemotherapy, a total of four patients (9.8%) had stable disease, and 37 patients (90.2%) had clinical response. Even, 12/41 patients (29.3%) achieved a complete clinical response. After chemoradiotherapy completion, 75.6% had a complete
radiological and histological response (primary site). No DCF cycle was delayed because of hematologic toxicity, and all of the DCF cycles were administered in the included patients. An unexpected low mucosal toxicity was also recorded.

Conclusion: DCF chemotherapy with pegfilgrastrim support, is safe, feasible and well tolerated. In the present study, this combination has allowed for an interesting dose intensity and for a high response after neoadjuvant DCF chemotherapy.

CARCINOMA OF THE HEAD AND NECK – PEGF ILGRASTIM – RADIATION THERAPY – INDUCTION – CHEMOTHERAPY



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