Acta oto-laryngologica · 2025
Comparison of the efficacy and safety of concurrent chemoradiotherapy with platinum-based or taxanes-based for LAHNSCC after induction chemotherapy.
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Liu Kun, Wei Jian, Gu Xiang, Chen Nanxiang, Ma Lin, Yang Shiming, Zhang Xinxin
Аннотация
BACKGROUND: No randomized trials confirm the efficacy of concurrent chemoradiotherapy (CCRT) in platinum-ineligible patients with locally advanced head and neck squamous cell carcinoma (LAHNSCC) post-induction chemotherapy (IC).
OBJECTIVES: This study evaluates the efficacy of platinum-based versus taxane-based CCRT after IC in LAHNSCC patients, excluding nasopharyngeal carcinoma, to assess the viability of taxanes as a platinum alternative.
MATERIALS AND METHODS: A retrospective analysis was conducted on 215 LAHNSCC patients treated with IC using nab-paclitaxel/docetaxel, cisplatin, and fluorouracil (AP/APF or TP/TPF). During CCRT, patients were divided into platinum and taxane groups. Survival rates, and safety profiles of nab-paclitaxel versus docetaxel were compared. All patients received Helical tomotherapy and Intensity-modulated radiotherapy at 60-70 Gy.
RESULTS: No significant differences were observed in CR rates, 3-year progression-free survival (PFS) (75.2 vs. 84.8%), or overall survival (OS) (72.1 vs. 84.1%) between taxane and platinum groups. Within the taxane group, CR rates and 3-year PFS showed no significant difference. However, the nab-paclitaxel group demonstrated significantly improved 3-year OS (80.9 vs. 67.6%) and disease-specific survival (DSS) (94.09 vs. 70.72%) compared to the docetaxel group.
CONCLUSIONS: Taxane-based CCRT after IC is as effective as platinum-based treatment with manageable toxicity. Nab-paclitaxel surpassed docetaxel in 3-year OS and DSS.
OBJECTIVES: This study evaluates the efficacy of platinum-based versus taxane-based CCRT after IC in LAHNSCC patients, excluding nasopharyngeal carcinoma, to assess the viability of taxanes as a platinum alternative.
MATERIALS AND METHODS: A retrospective analysis was conducted on 215 LAHNSCC patients treated with IC using nab-paclitaxel/docetaxel, cisplatin, and fluorouracil (AP/APF or TP/TPF). During CCRT, patients were divided into platinum and taxane groups. Survival rates, and safety profiles of nab-paclitaxel versus docetaxel were compared. All patients received Helical tomotherapy and Intensity-modulated radiotherapy at 60-70 Gy.
RESULTS: No significant differences were observed in CR rates, 3-year progression-free survival (PFS) (75.2 vs. 84.8%), or overall survival (OS) (72.1 vs. 84.1%) between taxane and platinum groups. Within the taxane group, CR rates and 3-year PFS showed no significant difference. However, the nab-paclitaxel group demonstrated significantly improved 3-year OS (80.9 vs. 67.6%) and disease-specific survival (DSS) (94.09 vs. 70.72%) compared to the docetaxel group.
CONCLUSIONS: Taxane-based CCRT after IC is as effective as platinum-based treatment with manageable toxicity. Nab-paclitaxel surpassed docetaxel in 3-year OS and DSS.