II trial of Docetaxel (D) and Cisplatin (C)
in locally advanced undifferentiated carcinoma of nasopharyngeal type
M. YAMOUNI - N.A. BENHADJI - Y. BELDJILALI - I. LAHLA - B. LARBAOUI
- M. BRAHIMI - A. AIT SAID - K. BOUZID - D. DJELLALI
Service d'Oncologie Médicale CHU d'Oran
ECCO 12, Copenhague , 21-25 septembre 2003
Aim of the study : To asses the antitumoral
efficacy and the toxicity of neoadjuvant DC in patients (pts)
with locally advanced UCNT (WHO type 3).
Patients and methods : previously
untreated pts with histologically diagnosed locally advanced UCNT
(stage IV A and IV B TNM/UICC 1997) were enrolled between April
2001 and April 2002 in this phase II study. Pts received D 75
mg/m2 and C 75 mg/m2 on day 1. Every pt received three cycles
in a neoadjuvant setting. Before radiotherapy (4 to 6 weeks after
the third cycle of DC). Pts were evaluated by clinical examination,
nasofibroscopy with biopsy and CT Scan of nasopahrynx.
Results : All patients were evaluable
for efficacy and toxicity. There are 63 pts (46 males, 19 females)
with a median age of 41 years (range 18-69) and a performance
status (WHO) of0-1 in 61 pts, 2 in pts. Fourteen pts had stage
IVA and 51 pts had stage IVB. Response rate for the 65 pts were
: complete pathologic response 44%. Partial response 46 %, stable
disease 7% and progression 3%. The overall response rate (ORR)
was 90 %. After 195 cycles, grade 3 and 4 toxicity (WHO) were
neutropenia (15,5%) febrile neutropenia (3%) anaemia (1,9%) nausea
and vomiting (23 %) diarrhoea (7%) mucositis (1%) reversible alopecia
(71%). Two patients had onycolysis.
Conclusion : DC is an effective regimen
with an acceptable safety profile in locally advanced UCNT.
Algeria has an intermediate incidence : 5 per 10 000
At least 60 % of patients with UCNT have locally advanced disease,
while 5 % to 6% have distant metastasis at diagnosis.
However, for stage IV UCNT, chemotherapy has now become an integral
part of treatment, along with radiotherapy.
The standard chemotherapy regimen is BEP (Cisplatin, Epirubicin,
Recent studies had demonstrated that Docetaxel is an active
cytotoxic in the head and neck cancers.
Aim of the study
To assess the antitumoral efficacy and toxicity of Docetaxel
and Cisplatin neo-adjuvant chemotherapy in patients with locally