Efficacy and toxicity of concurrent chemoradiotherapy in patients with advanced oropharyngeal squamous cell carcinoma

Purpose The aim of this study was to evaluate the feasibility and toxicity of concurrent chemoradiotherapy (CCRT) with docetaxel, cisplatin (CDDP) and 5-fluorouracil (5-FU) (TPF regimen) or with CDDP, 5-FU, methotrexate and leucovorin (PFML regimen) in previously untreated patients with advanced oropharyngeal squamous cell carcinoma (SCC). Methods Fifty-six eligible patients with stage III or IV oropharyngeal SCC were treated with CCRT. Forty-four patients were men and 12 were women, and the average age of the patients was 58.8 years (range, 37–72 years). In the TPF group, patients received CCRT with the TPF regimen [docetaxel (50 mg/m 2 , day 1), CDDP (60 mg/m 2 , day 4) and a continuous 5-FU infusion (600 mg/m 2 /day, days 1–5)]. In the PFML group, patients received CCRT with the PFML regimen [CDDP (60 mg/m 2 , day 4), a continuous 5-FU infusion (600 mg/m 2 /day, days 1–5), methotrexate (30 mg/m 2 , day 1) and leucovorin (10 mg/m 2 /day, days 1–5)]. The total radiation dose was between 66.6 and 70.2 Gy. Results The overall 5-year survival rate was 64.6% in all patients, 68.6% in the resectable group and 47.4% in the unresectable group. The 5-year disease-specific survival rate was 72.2% in all patients, 78.1% in the resectable group and 47.7% in the unresectable group. Regarding clinical stage, the 5-year disease-specific survival rates were 91% in stage III, 72% in stage IVa and 44% in stage IVb. Conclusion CCRT with TPF or PFML regimen for advanced oropharyngeal SCC is tolerable and effective, especially in patients with resectable disease.