Concurrent chemoradiotherapy with docetaxel, cisplatin, and fluorouracil for patients with advanced external auditory...

Concurrent chemoradiotherapy (CCRT) with docetaxel, cisplatin (CDDP), and fluorouracil (5-FU) (i.e. TPF regimen) has yielded favourable outcomes in treating advanced external auditory canal squamous cell carcinoma (EACSCC). However, safety and efficacy have not been compared across TPF-CCRT and CDDP-based regimens. This study thus aimed to assess the feasibility, safety, and efficacy of TPF-CCRT versus CDDP-CCRT.

This retrospective study evaluated 20 patients with T3/T4 EACSCC who underwent CCRT between 2007 and 2023. During radiotherapy, the TPF group (n = 10) received two cycles of 50 mg/m² docetaxel and 60 mg/m² CDDP on day 1, plus 600 mg/m² 5-FU on days 1-4. Meanwhile, the CDDP group (n = 10) received three cycles of CDDP (80 mg/m²) triweekly or two cycles of CDDP (60 mg/m²) on day 1 and 5-FU (600 mg/m²/day) on days 1-4 during RT. Treatment compliance, incidence of adverse events, progression-free survival (PFS), and overall survival (OS) were compared between the groups.

All patients completed radiotherapy. The incidence of grade ≥ 3 adverse events was not significantly different between the TPF and CDDP groups, but leukopenia (any grade) and alopecia occurred more frequently in the TPF group. Two-year PFS (80% vs. 20%, p < 0.01) and OS rates (100% vs. 40%, p < 0.01) were significantly higher in the TPF group.

Compared with CDDP-CCRT, TPF-CCRT has excellent feasibility and efficacy and acceptable toxicity for advanced EACSCC, making it a promising treatment option for this malignancy.