Abstract

Purpose: To compare and analyse chemoradiotherapy with either weekly docetaxel or weekly cisplatin for treatment of locally advanced head and neck cancer in terms of tumor response and toxicities. Methods: This was a comparative analytical study. Adult patients (age ≥ 18 years) with LAHNSCC planned for chemoradiation and Karnofsky performance status of >70% were randomly assigned in 1:1 to either radiation with concurrent docetaxel 20mg/ once weekly or concurrent cisplatin 30mg/ m2 for a maximum of six cycles. Comparison of treatment response and acute and late toxicities were done. Results: A total of 50 patients were enrolled in the study between September 2022 and February 2024. The overall response rate was slightly higher in the DocetaxelRT arm compared to the Cisplatin-RT arm (87% vs. 80%). Complete response rates were 34.8% in the Docetaxel-RT group and 20% in the Cisplatin-RT group (P = 0.25), while partial response rates were 52.8% and 60%, respectively (P = 0.58). In terms of toxicity, Grade III mucositis was significantly more common in the Docetaxel-RT arm (65.2%) compared to the Cisplatin-RT arm (28%). Additionally, the incidence of grade 3 acute skin reactions was higher with Docetaxel-RT (28.1% vs. 4%), as was the occurrence of subcutaneous fibrosis at six months posttreatment (13% vs. 8%). Conclusion: Weekly Docetaxel (20 mg/m²) administered concurrently with radiotherapy in patients with locally advanced head and neck cancer demonstrates a favorable toxicity profile and comparable efficacy to weekly Cisplatin. Further validation through larger phase II/III trials and multicentre studies is warranted to optimize dosing strategies and assess long-term outcomes, including survival benefits.

• 1.   Pignon JP, Le Maitre A, Maillard E, Bourhis J, Mach-Nc Collaborative Group. Meta-analysis of chemotherapy in head and neck cancer (MACH-NC): an update on 93 randomised trials and 17,346 patients. Radiotherapy and oncology. 2009 Jul 1;92(1):4-14.1
• 2.   Jacinto AA, Batalha Filho ES, Viana LD, De Marchi P, Capuzzo RD, Gama RR, Boldrini Junior D, Santos CR, Pinto GD, Dias JM, Canton HP. Feasibility of concomitant cisplatin with hypofractionated radiotherapy for locally advanced head and neck squamous cell carcinoma. BMC cancer. 2018 Dec;18:1-9.
• 3.   Schrijvers D, Vermorken JB. Role of taxoids in head and neck cancer. The Oncologist. 2000 Jun 1;5(3):199-208.
• 4.   Chaffey JT, Hellman S. Differing responses to radiation of murine bone marrow stem cells in 15 IJCER / Volume 13 Number 1/January - June 2025 relation to the cell cycle. Cancer Research. 1971 Nov 1;31(11):1613-5.
• 5.   Diaz JF, Andreu JM. Assembly of purified GDP-tubulin into microtubules induced by taxol and taxotere: reversibility, ligand stoichiometry, and competition. Biochemistry. 1993 Mar 1;32(11):2747-55.
• 6.   Pazdur R, Newman RA, Newman BM, Fuentes A, Benvenuto J, Bready B, Moore Jr D, Jaiyesimi I, Vreeland F, Bayssas MM, Raber MN. Phase I trial of Taxotere: five-day schedule. JNCI: Journal of the National Cancer Institute. 1992 Dec 2;84(23):1781-8.
• 7.   Colevas AD, Posner MR. Docetaxel in head and neck cancer: a review. American journal of clinical oncology. 1998 Oct 1;21(5):482-6.
• 8.   Al-Sarraf M. Treatment of locally advanced head and neck cancer: historical and critical review. Cancer control. 2002 Sep;9(5):387-99.
• 9.   Jeremic B, Shibamoto Y, Stanisavljevic B, Milojevic L, Milicic B, Nikolic N. Radiation therapy alone or with concurrent lowdose daily either cisplatin or carboplatin in locally advanced unresectable squamous cell carcinoma of the head and neck: a prospective randomized trial. Radiotherapy and Oncology. 1997 Apr 1;43(1):29-37.
• 10.   Suzuki M, Nishimura Y, Nakamatsu K, Kanamori S, Koike R, Kawamoto M, Mori K. Phase I study of weekly docetaxel infusion and concurrent radiation therapy for head and neck cancer. Japanese journal of clinical oncology. 2003 Jun 1;33(6):297-301.
• 11.   Kodaira T, Fuwa N, Furutani K, Tachibana H, Yamazaki T. Phase I trial of weekly docetaxel and concurrent radiotherapy for head and neck cancer in elderly patients or patients with complications. Japanese journal of clinical oncology. 2005 Apr 1;35(4):173-6.
• 12.   Al-Sarraf M. Treatment of locally advanced head and neck cancer: historical and critical review. Cancer control. 2002 Sep;9(5):387-99.
• 13.   Traynor AM, Richards GM, Hartig GK, Khuntia D, Cleary JF, Wiederholt PA, Bentzen SM, Harari PM. Comprehensive IMRT plus weekly cisplatin for advanced head and neck cancer: the University of Wisconsin experience. Head & neck. 2010 May;32(5):599-606.
• 14.   Adelstein DJ, Li Y, Adams GL, Wagner Jr H , Kish JA, Ensley JF, Schuller DE, Forastiere AA. An intergroup phase III comparison of standard radiation therapy and two schedules of concurrent chemoradiotherapy in patients with unresectable squamous cell head and neck cancer. Journal of clinical oncology. 2003 Jan 1;21(1):92-8.
• 15.   Chan AT, Leung SF, Ngan RK, Teo PM, Lau WH, Kwan WH, Hui EP, Yiu HY, Yeo W, Cheung FY, Yu KH. Overall survival after concurrent cisplatin–radiotherapy compared with radiotherapy alone in locoregionally advanced nasopharyngeal carcinoma. Journal of the National Cancer Institute. 2005 Apr 6;97(7):536-9.
• 16.   Calais G, Bardet E, Sire C, Alfonsi M, Bourhis J, Rhein B, Tortochaux J, Man YT, Auvray H, Garaud P. Radiotherapy with concomitant weekly docetaxel for Stages III/IV oropharynx carcinoma. Results of the 98-02 GORTEC Phase II trial. International Journal of Radiation Oncology* Biology* Physics. 2004 Jan 1;58(1):161-6.
• 17.   Kodaira T, Fuwa N, Furutani K, Tachibana H, Yamazaki T. Phase I trial of weekly docetaxel and concurrent radiotherapy for head and neck cancer in elderly patients or patients with complications. Japanese journal of clinical oncology. 2005 Apr 1;35(4):173-6.
• 18.   Tishler RB, Norris Jr CM, Colevas AD, Lamb CC, Karp D, Busse PM, Nixon A, Frankenthaler R, Lake Willcutt B, Costello R, Case M. A phase I/II trial of concurrent docetaxel and radiation after induction chemotherapy in patients with poor prognosis squamous cell carcinoma of the head and neck. Cancer. 2002 Oct 1;95(7):1472- 81.
• 19.   Rajesh I, Rajesh B, Selvamani B. Feasibility and response of concurrent weekly docetaxel with radical radiotherapy in locally advanced head and neck squamous cell carcinoma. Journal of Clinical and Diagnostic Research: JCDR. 2015 Mar 1;9(3):XC01.
• 20.   Kumar S, Pandey M, Lal P, Rastogi N, Das KJ, Dimri K. Concomitant boost radiotherapy with concurrent weekly cisplatin in advanced head and neck cancers: a phase II trial. Radiotherapy and oncology. 2005 May 1;75(2):186-92.
• 21.   Ang KK, Harris J, Garden AS, Trotti A, Jones CU, Carrascosa L, Cheng JD, Spencer SS, Forastiere A, Weber RS. Concomitant boost radiation plus concurrent cisplatin for advanced head and neck carcinomas: radiation therapy oncology group phase II trial 99- 14. Journal of clinical oncology. 2005 May 1;23(13):3008-15.
• 21.   Ang KK, Harris J, Garden AS, Trotti A, Jones CU, Carrascosa L, Cheng JD, Spencer SS, Forastiere A, Weber RS. Concomitant boost radiation plus concurrent cisplatin for advanced head and neck carcinomas: radiation therapy oncology group phase II trial 99- 14. Journal of clinical oncology. 2005 May 1;23(13):3008-15.
• 22.   Kang MH, Kang JH, Song HN, Jeong BK, Chai GY, Kang K, Woo SH, Park JJ, Kim JP. et al. A Comparative Analytical study of Chemo-Radiotherapy with either weekly Docetaxel or weekly Cisplatin for Treatment of Locally advanced Head and Neck Cancer 16 IJCER / Volume 13 Number 1/January - June 2025 Indian Journal of Cancer Education and Research weekly cisplatin in locally advanced stage IV head and neck squamous cell carcinoma. Cancer Research and Treatment: Official Journal of Korean Cancer Association. 2015 Jul 1;47(3):441-7.
• 23.   Liao JF, Zhang Q, Du XJ, Lan M, Liu S, Xia YF, Cai XY, Luo W. Concurrent chemoradiotherapy with weekly docetaxel versus cisplatin in the treatment of locoregionally advanced nasopharyngeal carcinoma: a propensity scorematched analysis. Cancer Communications. 2019 Dec;39(1):1-1.
• 24.   Wei WH, Cai XY, Xu T, Zhang GY, Wu YF, Feng WN, Lin L, Deng YM, Lu QX, Huang ZL. Concurrent weekly docetaxel chemotherapy in combination with radiotherapy for stage III and IVA-B nasopharyngeal carcinoma. Asian Pacific Journal of Cancer Prevention. 2012;13(3):785-9.
• 25.   New PZ, Jackson CE, Rinaldi D, Burris H, Barohn RJ. Peripheral neuropathy secondary to docetaxel (Taxotere). Neurology. 1996 Jan;46(1):108-11
• 1.   Pignon JP, Le Maitre A, Maillard E, Bourhis J, Mach-Nc Collaborative Group. Meta-analysis of chemotherapy in head and neck cancer (MACH-NC): an update on 93 randomised trials and 17,346 patients. Radiotherapy and oncology. 2009 Jul 1;92(1):4-14.1
• 2.   Jacinto AA, Batalha Filho ES, Viana LD, De Marchi P, Capuzzo RD, Gama RR, Boldrini Junior D, Santos CR, Pinto GD, Dias JM, Canton HP. Feasibility of concomitant cisplatin with hypofractionated radiotherapy for locally advanced head and neck squamous cell carcinoma. BMC cancer. 2018 Dec;18:1-9.
• 3.   Schrijvers D, Vermorken JB. Role of taxoids in head and neck cancer. The Oncologist. 2000 Jun 1;5(3):199-208.
• 4.   Chaffey JT, Hellman S. Differing responses to radiation of murine bone marrow stem cells in relation to the cell cycle. Cancer Research. 1971 Nov 1;31(11):1613-5.
• 5.   Diaz JF, Andreu JM. Assembly of puri𿿿ed GDP-tubulin into microtubules induced by taxol and taxotere: reversibility, ligand stoichiometry, and competition. Biochemistry. 1993 Mar 1;32(11):2747-55.
• 6.   Pazdur R, Newman RA, Newman BM, Fuentes A, Benvenuto J, Bready B, Moore Jr D, Jaiyesimi I, Vreeland F, Bayssas MM, Raber MN. Phase I trial of Taxotere: 𿿿ve-day schedule. JNCI: Journal of the National Cancer Institute. 1992 Dec 2;84(23):1781-8.
• 7.   Colevas AD, Posner MR. Docetaxel in head and neck cancer: a review. American journal of clinical oncology. 1998 Oct 1;21(5):482-6.
• 8.   Al-Sarraf M. Treatment of locally advanced head and neck cancer: historical and critical review. Cancer control. 2002 Sep;9(5):387-99.
• 9.   Jeremic B, Shibamoto Y, Stanisavljevic B, Milojevic L, Milicic B, Nikolic N. Radiation therapy alone or with concurrent lowdose daily either cisplatin or carboplatin in locally advanced unresectable squamous cell carcinoma of the head and neck: a prospective randomized trial. Radiotherapy and Oncology. 1997 Apr 1;43(1):29-37.
• 10.   Suzuki M, Nishimura Y, Nakamatsu K, Kanamori S, Koike R, Kawamoto M, Mori K. Phase I study of weekly docetaxel infusion and concurrent radiation therapy for head and neck cancer. Japanese journal of clinical oncology. 2003 Jun 1;33(6):297-301.
• 11.   Kodaira T, Fuwa N, Furutani K, Tachibana H, Yamazaki T. Phase I trial of weekly docetaxel and concurrent radiotherapy for head and neck cancer in elderly patients or patients with complications. Japanese journal of clinical oncology. 2005 Apr 1;35(4):173-6.
• 12.   Al-Sarraf M. Treatment of locally advanced head and neck cancer: historical and critical review. Cancer control. 2002 Sep;9(5):387-99.
• 13.   Traynor AM, Richards GM, Hartig GK, Khuntia D, Cleary JF, Wiederholt PA, Bentzen SM, Harari PM. Comprehensive IMRT plus weekly cisplatin for advanced head and neck cancer: the University of Wisconsin experience. Head & neck. 2010 May;32(5):599-606.
• 14.   Adelstein DJ, Li Y, Adams GL, Wagner Jr H, Kish JA, Ensley JF, Schuller DE, Forastiere AA. An intergroup phase III comparison of standard radiation therapy and two schedules of concurrent chemoradiotherapy in patients with unresectable squamous cell head and neck cancer. Journal of clinical oncology. 2003 Jan 1;21(1):92-8.
• 15.   Chan AT, Leung SF, Ngan RK, Teo PM, Lau WH, Kwan WH, Hui EP, Yiu HY, Yeo W, Cheung FY, Yu KH. Overall survival after concurrent cisplatin–radiotherapy compared with radiotherapy alone in locoregionally advanced nasopharyngeal carcinoma. Journal of the National Cancer Institute. 2005 Apr 6;97(7):536-9.
• 16.   Calais G, Bardet E, Sire C, Alfonsi M, Bourhis J, Rhein B, Tortochaux J, Man YT, Auvray H, Garaud P. Radiotherapy with concomitant weekly docetaxel for Stages III/IV oropharynx carcinoma. Results of the 98-02 GORTEC Phase II trial. International Journal of Radiation Oncology* Biology* Physics. 2004 Jan 1;58(1):161-6.
• 17.   Kodaira T, Fuwa N, Furutani K, Tachibana H, Yamazaki T. Phase I trial of weekly docetaxel and concurrent radiotherapy for head and neck cancer in elderly patients or patients with complications. Japanese journal of clinical oncology. 2005 Apr 1;35(4):173-6.
• 18.   Tishler RB, Norris Jr CM, Colevas AD, Lamb CC, Karp D, Busse PM, Nixon A, Frankenthaler R, Lake Willcutt B, Costello R, Case M. A phase I/II trial of concurrent docetaxel and radiation after induction chemotherapy in patients with poor prognosis squamous cell carcinoma of the head and neck. Cancer. 2002 Oct 1;95(7):1472-81.
• 19.   Rajesh I, Rajesh B, Selvamani B. Feasibility and response of concurrent weekly docetaxel with radical radiotherapy in locally advanced head and neck squamous cell carcinoma. Journal of Clinical and Diagnostic Research: JCDR. 2015 Mar 1;9(3):XC01.
• 20.   Kumar S, Pandey M, Lal P, Rastogi N, Das KJ, Dimri K. Concomitant boost radiotherapy with concurrent weekly cisplatin in advanced head and neck cancers: a phase II trial. Radiotherapy and oncology. 2005 May 1;75(2):186-92.
• 21.   Ang KK, Harris J, Garden AS, Trotti A, Jones CU, Carrascosa L, Cheng JD, Spencer SS, Forastiere A, Weber RS. Concomitant boost radiation plus concurrent cisplatin for advanced head and neck carcinomas: radiation therapy oncology group phase II trial 99-14. Journal of clinical oncology. 2005 May 1;23(13):3008-15.
• 22.   Kang MH, Kang JH, Song HN, Jeong BK, Chai GY, Kang K, Woo SH, Park JJ, Kim JP. Concurrent chemoradiation with low-dose weekly cisplatin in locally advanced stage IV head and neck squamous cell carcinoma. Cancer Research and Treatment: Of𿿿cial Journal of Korean Cancer Association. 2015 Jul 1;47(3):441-7
• 23.   Liao JF, Zhang Q, Du XJ, Lan M, Liu S, Xia YF, Cai XY, Luo W. Concurrent chemoradiotherapy with weekly docetaxel versus cisplatin in the treatment of locoregionally advanced nasopharyngeal carcinoma: a propensity scorematched analysis. Cancer Communications. 2019 Dec;39(1):1-1.
• 24.   Wei WH, Cai XY, Xu T, Zhang GY, Wu YF, Feng WN, Lin L, Deng YM, Lu QX, Huang ZL. Concurrent weekly docetaxel chemotherapy in combination with radiotherapy for stage III and IVA-B nasopharyngeal carcinoma. Asian Paci𿿿c Journal of CancerPrevention.2012;13(3):785-9.
• 25.   New PZ, Jackson CE, Rinaldi D, Burris H, Barohn RJ. Peripheral neuropathy secondary to docetaxel (Taxotere). Neurology. 1996 Jan;46(1):108-11.

Data Sharing Statement

Funding