Induction Chemotherapy with Docetaxel, Cisplatin, 5 Fu, Followed by Radiotherapy Plus Cisplatin or Cetuximab, in Organ Preservation in Piriform Sinus Carcinomas.

e17011 Background: Only few studies report organ preservation in piriform sinus carcinomas (PSC), with no publication on induction chemotherapy (IC) with docetaxel, cisplatine, 5FU (DCF) followed by radiotherapy plus cisplatin (RTCis) or cetuximab (RTCet). We assessed compliance, survival and organ preservation after IC by DCF followed by RTCis or RTCet in a retrospective multicentric review of patients (pts) with advanced PSC. Methods: We analyzed retrospectively 88 pts with advanced PSC treated between 2005 and 2011 in 3 tertiary care centers with organ preservation protocol strategy ongoing in each center. DCF was followed by RTCet (56.5%) in 1 center and by RTCis(42%) in the 2 others. Primary endpoints were acute toxicity and compliance to IC and RTCis compliance compared with RTCet. Secondary endpoints were overall survival (OS), disease free survival (DFS) and laryngectomy free survival (LFS). Results: Within the 88 pts, 21.6% were stage III and 72.7% stage IV; 81% completed the full course of IC. For 64.8% of pts no toxicity was reported. The main side effect observed was neutropenia (18.2%). Two deaths (2%) were directly related to the IC. Concerning the radiotherapy, 59% of the pts had full dose concomitant cisplatin versus 85% with cetuximab (p<0.001). Mean follow up was 23.5 months. At 5 years, OS rate was 35.5%, [CI 95% 24.6%-50.7%]. At 4 years DFS rate was 24% [CI 95% 15.5%-38%]. Factors affecting survival were IC response (ICR) (p<0.001) and stage of the disease (stage II>stage IV, p<0.001). No significant difference in survival was found between patients with RTCis or RTCet. At 4 years, LFS rate was 73% [IC 95% 56%-87.6%]. Factor affecting this LFS rate was ICR (p<0.05). Conclusions: IC with DPF followed by RTCis or RTCet allowed high organ preservation rates with acceptable toxicities. Cetuximab seemed to be better tolerated than cisplatin, improving compliance to the treatment. OS favorably compared with historical data of concurrent chemoradiation