Author/Authors :
Ameri، Ahmad نويسنده Associate Professor of Radiation Oncology , , Azghandi، Samira نويسنده Radiation oncologist , , Khorsandi، Mohammad Taghi نويسنده Professor of Otorhinolaryngology, Otorhinolaryngology Research Center, Amir-Alam Hospital , , Karimi Sangchini، Ebrahim نويسنده Postgraduate Student, watershed management. Gorgan university, Iran , , Yazdani، Nasrin نويسنده Tehran university of medical science, , , Haghighatkhah، Hamid Reza نويسنده Associate professor of radiology , , Malekshoar، Mehran نويسنده Radiologist ,
Abstract :
Introduction: Response to chemotherapy is a reliable marker for radiation sensitivity in patients with locally
advanced head and neck squamous cell carcinoma. We compared the response rate and toxicity after two cycles
of chemotherapy using Docetaxel / Cisplatin /5FU or Cisplatin / 5FU among these patients.
Materials and methods: We randomly assigned 16 to 75 years old patients with stage III or IV non-metastatic
locally advanced head and neck squamous cell carcinoma to receive either DCF or CF every 3 weeks for two
cycles. All patients who received at least one and two cycles of chemotherapy were considered for toxicity and
response evaluation respectively.
Results: Seventy patients underwent randomization, 36 and 34 patients were assigned to Docetaxel / Cisplatin
/5FU and Cisplatin / 5FU groups respectively. Three and 8 patients were excluded after randomization and before
receiving any chemotherapy in Docetaxel / Cisplatin /5FU and Cisplatin / 5FU groups respectively. Finally 30 and
25 in Docetaxel / Cisplatin /5FU group and 25 and 23 patients in Cisplatin / 5FU group were evaluated for toxicity
and response respectively. Response rate (complete and partial response) was %83 (35% complete and 48%
partial response) and %84(16% complete and 68% partial response) in Cisplatin / 5FU and Docetaxel / Cisplatin
/5FU groups respectively (P= 0.28). There was no differences in complete response rate between two groups
(P=0.18). Neutropenia, phlebitis and mucositis were more common in Cisplatin / 5FU group without statistically
significant difference. Constipation was significantly more common in Cisplatin / 5FU group (P= 0.008). Diarrhea,
alopecia and febrile neutropenia were significantly more common in Docetaxel / Cisplatin /5FU group (P= 0.006,
0.01 and 0.03 respectivly).
Conclusion: We could not find any significant differences between response to Docetaxel / Cisplatin /5FU
and Cisplatin /5FU combination chemotherapy among Iranian patients with locally advanced head and neck
squamous cell carcinoma. However, for better evaluation, larger studies with better designs are being conducted
in our center.
