Value of personalized chemotherapy dose adjustment in patients with advanced head and neck cancer / Abdelhamid Mohamed Fouad ; Supervised Magdy Mohamed Saber , Tarek Hamed Showman , Yasser Ahmed Sallam

Thesis (Ph.D.) - Cairo University - National Cancer Institute - Department of Oncology-Medical

Background: Tumors of the head and neck (HNC) represent a heterogeneous group of neoplasms. These tumors may differ in location, pathogenesis, tumor biology, treatment, prognosis, and effect on quality of life. The docetaxel, cisplatin and infusional 5-fluorouracil (5-FU) regimen (TPF) is the standard for induction chemotherapy in the loco regionally advanced HNC, however, they are associated with substantial hematologic toxicity and a high complication rate. A number of studies have reported substantial higher response rates and better tolerability when comparing pharmacokinetically guided (PK-guided) versus body surface area (BSA)-based chemotherapy dosing results. A paucity of data exists on PK-guided-based chemotherapy dosing in HNCs in literature. Objective: The aim of this study is to demonstrate the value of PK guided docetaxel and 5-FU dose adjustments in controlling toxicity, and improving efficacy and tolerance for patients with advanced HNC. Patients and methods: The study included 39 patients with stage III and IV HNC whom were diagnosed, treated and followed in the NCI in the period between April 2013 till December 2016. All patients will receive same chemotherapy regimen (TPF), where the first cycle will be given according to BSA-based dosing, then docetaxel dose and 5-FU dose will be adjusted for each patient before every cycle, beginning with the second cycle based on individual results of plasma concentration measurements

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