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Phase II Pilot Study of Docetaxel, Cisplatin, and Fluorouracil Followed By Accelerated Fractionation/Concomitant Boost Radiotherapy and Concurrent Cisplatin in Patients With Stage III or IV Squamous Cell Carcinoma of the Head and Neck

Alternate Title
Basic Trial Information
Objectives
Entry Criteria
Expected Enrollment
Outline
Published Results
Trial Contact Information
Registry Information

Alternate Title

Combination Chemotherapy and Radiation Therapy in Treating Patients With Stage III or Stage IV Head and Neck Cancer

Basic Trial Information

Phase
Type
Status
Age
Sponsor
Protocol IDs

Phase II

Treatment

Closed

18 and over

NCI

SWOG-S0216
S0216, NCT00054054

Objectives

Determine the overall survival of patients with stage III or IV squamous cell head and neck cancer treated with docetaxel, cisplatin, and fluorouracil followed by accelerated fractionation/concomitant boost radiotherapy and cisplatin.
Determine the unconfirmed complete response rate in these patients after treatment with induction chemotherapy.
Determine the overall complete response rate (confirmed and unconfirmed) in patients treated with this regimen.
Determine the toxic effects of this regimen in these patients.

Entry Criteria

Disease Characteristics:

Histologically confirmed squamous cell carcinoma of the head and neck (excluding lip, nasopharynx, paranasal sinus, and salivary gland) by biopsy or fine needle aspirate of the primary lesion or neck mass
- Stage III or IV disease

No evidence of distant metastases
- Negative chest x-ray

Primary site in the head and neck region must be identified
- No unknown primary site

Considered to be appropriate for definitive radiotherapy with curative intent

Prior/Concurrent Therapy:

Biologic therapy

Not specified

Chemotherapy

No prior chemotherapy

Endocrine therapy

Not specified

Radiotherapy

See Disease Characteristics
No prior radiotherapy

Surgery

No prior surgery for head or neck cancer

Patient Characteristics:

Age

18 and over

Performance status

Zubrod 0-1

Life expectancy

Not specified

Hematopoietic

Granulocyte count greater than 1,500/mm³
Platelet count greater than 100,000/mm³

Hepatic

Bilirubin no greater than upper limit of normal (ULN)
Alkaline phosphatase less than 2 times ULN
ALT or AST less than 1.5 times ULN

Renal

Creatinine less than 1.5 mg/dL

Cardiovascular

No myocardial infarction within the past 3 months
No unstable or uncontrolled angina

Other

Not pregnant or nursing
Fertile patients must use effective contraception
No other prior malignancy within the past 5 years except adequately treated basal cell or squamous cell skin cancer, carcinoma in situ of the cervix, or adequately treated stage I or II cancer currently in complete remission
No evidence of pre-existing peripheral neuropathy
No active systemic infection
No history of hypersensitivity reaction to products containing polysorbate 80

Expected Enrollment

A total of 60 patients will be accrued for this study within 2 years.

Outline

Induction Chemotherapy: Patients receive docetaxel IV over 1 hour and cisplatin IV over 30-60 minutes on day 1 and fluorouracil IV continuously on days 1-4. Treatment repeats every 21 days for 2 courses in the absence of unacceptable toxicity.

Chemoradiotherapy: Beginning within 3-4 weeks after administration of the second course of induction chemotherapy, patients receive accelerated fractionation radiotherapy once daily, 5 days per week, for 6 weeks with concomitant boost radiotherapy once daily, 5 days a week, for the last 2.5 weeks of radiotherapy. Patients also receive concurrent cisplatin IV over 30-60 minutes on days 1 and 22.

Patients are followed every 2 months for 1 year, every 3 months for 2 years, every 4 months for 1 year, and then every 6 months for 1 year.

Published Results

Adelstein DJ, Moon J, Hanna E, et al.: S0216: a Southwest Oncology Group (SWOG) phase II trial of docetaxel (T), cisplatin (P), and fluorouracil (F) induction followed by accelerated fractionation/concomitant boost (AF/CB) radiotherapy (RT) and concurrent cisplatin for advanced head and neck squamous cell cancer (HNSCC). [Abstract] J Clin Oncol 25 (Suppl 18): A-6014, 302s, 2007.

Trial Contact Information

Trial Lead Organizations

Southwest Oncology Group

David Adelstein, MD, Protocol chair
Ph: 216-444-9310; 800-862-7798

Registry Information

Official Title		Docetaxel (NSC-628503), Cisplatin (NSC-119875), And 5-Fluorouracil (NSC-19893) Induction Chemotherapy Followed By Accelerated Fractionation/Concomitant Boost Radiation And Concurrent Single Agent Cisplatin (NSC-119875), In Patients With Advanced Squamous Cell Head And Neck Cancer

Trial Start Date		2003-04-01

Registered in ClinicalTrials.gov		NCT00054054

Date Submitted to PDQ		2002-12-16

Information Last Verified		2005-12-06

NCI Grant/Contract Number		U10-CA32102

Note: The purpose of most clinical trials listed in this database is to test new cancer treatments, or new methods of diagnosing, screening, or preventing cancer. Because all potentially harmful side effects are not known before a trial is conducted, dose and schedule modifications may be required for participants if they develop side effects from the treatment or test. The therapy or test described in this clinical trial is intended for use by clinical oncologists in carefully structured settings, and may not prove to be more effective than standard treatment. A responsible investigator associated with this clinical trial should be consulted before using this protocol.