Chemotherapy advances in locally advanced head and neck cancer

Table 1 DeCIDE and PARADIGM Protocols

	DeCIDE	PARADIGM
Stages	IV	III, IV
Arm 1 (standard)	CRT CRT: five 14 d cycles of docetaxel (day 1), fluorouracil (day 0-4) and hydroxyurea (day 0-4) with twice daily radiation (day 1-5)	CRT cisplatin (100 mg/m2) Q 3 wk, 12 cycles Radiation: accelerated concomitant boost over 6 wk (72 Gy)
Arm 2 (experimental, induction)	TPF (2) → CRT TPF two cycles: docetaxel 75 mg/m2 day 1, cisplatin 100 mg /m2 day 1, fluorouracil 1000 mg/m per day continuous for 5 d CRT: five 14 d cycles of docetaxel (day 1), fluorouracil (day 0-4) and hydroxyurea (day 0-4) with twice daily radiation (day 1-5)	TPF (3) → CRT TPF three cycles: docetaxel 75 mg/m21, cisplatin 100 mg/m2 day1, fluorouracil 1000 mg/m2 continuous for 4 d Responders to induction: CRT (carboplatin AUC 1.5, weekly) Poor responders to induction CRT (docetaxel 20 mg/m2 weekly) Radiation: accelerated concomitant boost over 6 wk (72 Gy) for poor responders. Induction chemotherapy responders 70 Gy over 7 wk

¹Statistically significant. CRT: Chemoradiation.