Concurrent chemoradiotherapy with docetaxel, cisplatin, and 5-fluorouracil for T3 N0 glottic carcinoma without vocal cord fixation

Abstract Background Reports on the treatment results of chemoradiotherapy (CRT) for T3 N0 glottic carcinoma without vocal cord fixation are limited. We retrospectively evaluated the efficacy and toxicity of concurrent chemoradiotherapy (CCRT) with docetaxel, cisplatin, and 5-fluorouracil (TPF) for T3 N0 glottic carcinoma without vocal cord fixation. Methods Twenty-five patients were treated with TPF-CCRT. The chemotherapy consisted one or two cycles of TPF as follows: docetaxil (50 mg/m2), cisplatin (60 mg/m2), and 5-FU (600 mg/m2/day for 5 days). RT was delivered with a once-daily fraction of 2 Gy without elective nodal irradiaion (ENI). After the RT of 40 Gy and one cycle of chemotherapy, five patients (20%) were judged as having no tumor regression and underwent surgery. The remaining 20 patients underwent RT with a median total dose of 66 Gy. Results Of the five patients who underwent surgery after the delivery of 40 Gy, two showed residual carcinoma pathologically and the other three were confirmed to have complete pathological response to the treatment. During the follow-up period after a series of therapies, one patient had local failure. None of the patients exhibited regional or distant failure. The 5-year local control, laryngeal preservation, and overall survival rates were 87%, 92%, and 95%, respectively. Neutropenia was frequently observed during the treatment but was manageable in all the cases. No acute toxicities of grade 5 or late toxicities ≥ grade 3 were observed. Conclusions In this study, TPF-CCRT provided excellent tumor control with acceptable toxicities. Intensive local treatment with CCRT while omitting ENI is a reasonable approach for T3 N0 glottic carcinoma without vocal cord fixation.