Universitätsklinikum Frankfurt am Main R. Knecht Universitätsklinikum Frankfurt am Main R. Knecht Induction chemotherapy TPF 3 Cycles Docetaxel 75mg/m

UniversitätsklinikumUniversitätsklinikumFrankfurt am MainFrankfurt am MainR. KnechtR. Knecht


Induction chemotherapy TPF Induction chemotherapy TPF 3 Cycles3 Cycles

Docetaxel 75mg/mDocetaxel 75mg/m22 d1 d1

Cisplatin 100mg/mCisplatin 100mg/m2 2 d1d1

5-FU 1000mg/m5-FU 1000mg/m2 2 d1-4d1-4

Induction chemotherapy TPF Induction chemotherapy TPF 3 Cycles3 Cycles

Docetaxel 75mg/mDocetaxel 75mg/m22 d1 d1

Cisplatin 100mg/mCisplatin 100mg/m2 2 d1d1

5-FU 1000mg/m5-FU 1000mg/m2 2 d1-4d1-4

RadiochemotherapyRadiochemotherapy 70 Gy + Cisplatin 100 mg /m70 Gy + Cisplatin 100 mg /m22 d1, 22, 43 d1, 22, 43

RadiochemotherapyRadiochemotherapy 70 Gy + Cisplatin 100 mg /m70 Gy + Cisplatin 100 mg /m22 d1, 22, 43 d1, 22, 43

Laryngoprotect-StudyLaryngoprotect-StudyR. Knecht et al.R. Knecht et al.

Laryngoprotect-StudyLaryngoprotect-StudyR. Knecht et al.R. Knecht et al.



Regions and stages in %Regions and stages in %Regions and stages in %Regions and stages in %

55%55%

24%24%

21%21%

T/NT/N

4

4

13

21

2

3

3

8

NN11 NN22 NN33

2525

3434

2525

3434

2

3

-

5

TT22

TT33

TT44

15

35

50

100

NN00

Stage IIStage II Stage IIIStage III Stage IVStage IV

7

66

n=103n=103



Toxicity Toxicity (WHO Grad III / IV)(WHO Grad III / IV)Toxicity Toxicity (WHO Grad III / IV)(WHO Grad III / IV)

RenalRenal 25%25%

Afebrile Neutropenia Afebrile Neutropenia 95%95%

Nausea/VomitingNausea/Vomiting 25%25%

Mucositis Mucositis 10%10%

Sensory NeuropathySensory Neuropathy 10%10%

4%4%

47%47%

20%20%

43%43%

5%5%

InductionInductionchemotherapychemotherapy

Radio-Radio-chemotherapychemotherapy



ResultsResultsafter TPF - Polychemotherapy (3 Cycles)after TPF - Polychemotherapy (3 Cycles)


SupraglottisSupraglottis

GlottisGlottis

Hypopharynx Hypopharynx

SupraglottisSupraglottis

GlottisGlottis

Hypopharynx Hypopharynx

RRRRRRRR

76%76%

73%73%

92%92%

79%79%

76%76%

73%73%

92%92%

79%79%

41%41%

53%53%

54%54%

47%47%

41%41%

53%53%

54%54%

47%47%

CRCRCRCR



postpost



prae

S. A., T3N3M0



postprae

B. W., T2N1M0





prae

B. W., T2N1M0post

ResultsResultsafter TPF - Polychemotherapy(3 Cycles)after TPF - Polychemotherapy(3 Cycles)

ResultsResultsafter TPF - Polychemotherapy(3 Cycles)after TPF - Polychemotherapy(3 Cycles)



postpostpraeprae

M. B., T2N1M0M. B., T2N1M0





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postpostprae prae

B. H., T2N2bM0B. H., T2N2bM0





postpost


benötigt.



benötigt.


benötigt.

prae prae

G. H., T2N2bM0G. H., T2N2bM0





postpost


benötigt.



benötigt.


benötigt.

prae prae

J. H., T2N2bM0J. H., T2N2bM0





Induction chemotherapy Induction chemotherapy 3 Cycles3 Cycles

Cisplatin (100mg/mCisplatin (100mg/m22) ) 5 Fluorouracil (4000mg/m5 Fluorouracil (4000mg/m22))

Docetaxel (75mg/mDocetaxel (75mg/m22))




Laryngoprotect n = 103

RadiochemotherapyRadiochemotherapy (70Gy)

Cisplatin (3x 100mg/m2)



74% 74% 75%75%

2% 2% 93%93%

74% 74% 75%75%

2% 2% 93%93%

Larynx preservationLarynx preservationDisease free surv.Disease free surv.Distant metastasisDistant metastasisSurvivalSurvival


2 years

ResultsResultsHypopharynxHypopharynxResultsResultsHypopharynxHypopharynx

Knecht R . et al. Knecht R . et al. (2004)(2004) JOURNAL OF CLINICAL ONCOLOGY 22 (14): 502S-502S 5559JOURNAL OF CLINICAL ONCOLOGY 22 (14): 502S-502S 5559



Induktion chemotherapy Induktion chemotherapy 3 Cycles3 Cycles



Induktion chemotherapy Induktion chemotherapy 3 Cycles3 Cycles



2 years

Laryngoprotect n = 103Laryngoprotect n = 103Laryngoprotect n = 103Laryngoprotect n = 103

91% 91% 85%85%

0% 0% 94%94%

91% 91% 85%85%

0% 0% 94%94%







ResultsResultsLarynxLarynx











2 years

Laryngoprotect n = 103Laryngoprotect n = 103Laryngoprotect n = 103Laryngoprotect n = 103

91% 91% 85%85%

0% 0% 94%94%

91% 91% 85%85%

0% 0% 94%94%













RTOG 91-11 n = 172

88% 88% 61%61%

8% 8% 74%74%

88% 88% 61%61%

8% 8% 74%74%




Laryngoprotect 2Laryngoprotect 2Laryngoprotect 2Laryngoprotect 2















22



Induction chemotherapy TPF 3Cycles Docetaxel 75mg/m2 d1Cisplatin 100mg/m2 d15-FU 1000mg/m2 d1-4


Radiochemotherapy Radiochemotherapy 70 Gy (2 Gy/d; 5x/week) Cisplatin, (300mg/m70 Gy (2 Gy/d; 5x/week) Cisplatin, (300mg/m2 2 total)total)

Radiochemotherapy Radiochemotherapy 70 Gy (2 Gy/d; 5x/week) Cisplatin, (300mg/m70 Gy (2 Gy/d; 5x/week) Cisplatin, (300mg/m2 2 total)total)


Cetuximab (400 mg d1; 250mg ab d8 wöchtl)(400 mg d1; 250mg ab d8 wöchtl)


Cetuximab (400 mg d1; 250mg ab d8 wöchtl)(400 mg d1; 250mg ab d8 wöchtl)

International principal investigator: R. KnechtInternational principal investigator: R. KnechtInternational principal investigator: R. KnechtInternational principal investigator: R. Knecht

Stage III/IVStage III/IVStage III/IVStage III/IV

EGFR-Antibody EGFR-Antibody Neoadjuvant Primary TherapyNeoadjuvant Primary Therapy EGFR-Antibody EGFR-Antibody

Neoadjuvant Primary TherapyNeoadjuvant Primary Therapy

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Universitätsklinikum Frankfurt am Main R. Knecht Universitätsklinikum Frankfurt am Main R. Knecht Induction chemotherapy TPF 3 Cycles Docetaxel 75mg/m