Induction chemotherapy (IC) is a treatment strategy used for patients with locally advanced head and neck squamous cell carcinoma (HNSCC). It involves administering chemotherapy before the main treatment, such as surgery or radiation, to shrink tumors and potentially improve outcomes.

The most commonly used regimen for induction chemotherapy in head and neck cancers is the TPF regimen, which includes:

– Docetaxel: 75 mg/m² administered intravenously on day 1.

– Cisplatin: 75 mg/m² administered intravenously on day 1.

– 5-Fluorouracil (5-FU): 750 mg/m²/day administered as a continuous intravenous infusion for four to five days.

Dosing and Cycle Duration

– The TPF regimen is typically administered every three weeks for three to four cycles.

– After completing induction chemotherapy, patients usually proceed to chemoradiotherapy within three to four weeks.

 Efficacy

– Induction chemotherapy can reduce tumor size, making subsequent treatments like surgery or radiation more effective.

– It has been shown to decrease the risk of distant metastases, particularly in high-risk patients.

– However, its overall survival benefit compared to concurrent chemoradiotherapy alone is still debated, and it is often used selectively.

Induction chemotherapy is primarily indicated for:

– Locally advanced squamous cell carcinoma of the head and neck, particularly in cases where the tumor is bulky or borderline resectable.

– Patients with a high risk of distant metastatic disease.

– Situations where immediate surgery or radiation is not feasible due to patient condition or logistical reasons.