{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,3]],"date-time":"2026-10-03T22:32:51Z","timestamp":1791066771421,"version":"4.1.0"},"reference-count":41,"publisher":"MDPI AG","issue":"1","license":[{"start":{"date-parts":[[2018,12,22]],"date-time":"2018-12-22T00:00:00Z","timestamp":1545436800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Cancers"],"abstract":"<jats:p>Induction chemotherapy (IC) in locally advanced head and neck squamous cell carcinoma (LA HNSCC) has been used for decades. However, its role is yet to be clearly defined outside of larynx preservation. Patients with high risk of distant failure might potentially benefit from sequential treatment. It is now widely accepted that TPF (docetaxel, cisplatin, and fluorouracil) is the standard IC regimen. Essays that have compared this approach with the standard of care, concurrent chemoradiotherapy (CCRT), are mostly inconclusive. Radiotherapy (RT) can be used in the post-IC setting and be sensitized by chemotherapy or cetuximab. Again, no consensus exists but there seems to be trend in favor of potentiation by cisplatin. Less toxic schemes of IC are tested as toxicity is a major issue with TPF. IC might have an interesting role in human papilloma virus (HPV)-related LA HNSCC and lead to CCRT de-escalation.<\/jats:p>","DOI":"10.3390\/cancers11010015","type":"journal-article","created":{"date-parts":[[2018,12,24]],"date-time":"2018-12-24T10:37:49Z","timestamp":1545647869000},"page":"15","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":23,"title":["Induction Chemotherapy in Head and Neck Squamous Cell Carcinoma: A Question of Belief"],"prefix":"10.3390","volume":"11","author":[{"given":"Andy","family":"Karabajakian","sequence":"first","affiliation":[{"name":"Rh\u00f4ne-Alpes, Centre de Lutte Contre le Cancer L\u00e9on B\u00e9rard, 69008 Lyon, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Max","family":"Gau","sequence":"additional","affiliation":[{"name":"Rh\u00f4ne-Alpes, Centre de Lutte Contre le Cancer L\u00e9on B\u00e9rard, 69008 Lyon, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Thibault","family":"Reverdy","sequence":"additional","affiliation":[{"name":"Rh\u00f4ne-Alpes, Centre de Lutte Contre le Cancer L\u00e9on B\u00e9rard, 69008 Lyon, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eve-Marie","family":"Neidhardt","sequence":"additional","affiliation":[{"name":"Rh\u00f4ne-Alpes, Centre de Lutte Contre le Cancer L\u00e9on B\u00e9rard, 69008 Lyon, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"J\u00e9r\u00f4me","family":"Fayette","sequence":"additional","affiliation":[{"name":"Rh\u00f4ne-Alpes, Centre de Lutte Contre le Cancer L\u00e9on B\u00e9rard, 69008 Lyon, France"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2018,12,22]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"524","DOI":"10.1001\/jamaoncol.2016.5688","article-title":"Global, regional, and national cancer incidence, mortality, years of life lost, years lived with disability, and disability-adjusted life-years for 32 cancer groups, 1990 to 2015: A systematic analysis for the Global Burden of Disease Study","volume":"3","author":"Fitzmaurice","year":"2017","journal-title":"JAMA Oncol."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"7","DOI":"10.3322\/caac.21387","article-title":"Cancer statistics","volume":"67","author":"Siegel","year":"2017","journal-title":"CA Cancer J. Clin."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"2130","DOI":"10.1016\/j.ejca.2015.07.043","article-title":"Prognoses and improvement for head and neck cancers diagnosed in Europe in early 2000s: The EUROCARE-5 population-based study","volume":"51","author":"Gatta","year":"2015","journal-title":"Eur. J. Cancer"},{"key":"ref_4","unstructured":"El-Naggar, A.K., Chan, J.K.C., Takata, T., and Slootweg, P.J. (2017). WHO Classification of Head and Neck Tumours, International Agency for Research on Cancer. [4th ed.]."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"3235","DOI":"10.1200\/JCO.2015.61.6995","article-title":"Epidemiology of human papillomavirus-positive head and neck squamous cell carcinoma","volume":"33","author":"Gillison","year":"2015","journal-title":"J. Clin. Oncol."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"v184","DOI":"10.1093\/annonc\/mdq185","article-title":"Squamous cell carcinoma of the head and neck: EHNS-ESMO-ESTRO Clinical Practice Guidelines for diagnosis, treatment and follow-up","volume":"21","author":"Gregoire","year":"2010","journal-title":"Ann. Oncol."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"4","DOI":"10.1016\/j.radonc.2009.04.014","article-title":"Meta-analysis of chemotherapy in head and neck cancer (MACH-NC): An update on 93 randomised trials and 17 346 patients","volume":"92","author":"Pignon","year":"2009","journal-title":"Radiother. Oncol."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"1714","DOI":"10.1093\/jnci\/djh306","article-title":"Randomized phase III trial of neoadjuvant chemotherapy in head and neck cancer: 10-Year follow-up","volume":"96","author":"Zorat","year":"2004","journal-title":"J. Natl. Cancer Inst."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"2854","DOI":"10.1200\/JCO.2012.47.7802","article-title":"Taxane-cisplatin-fluorouracil as induction chemotherapy in locally advanced head and neck cancers: An individual patient data meta-analysis of the meta-analysis of chemotherapy in head and neck cancer group","volume":"31","author":"Blanchard","year":"2013","journal-title":"J. Clin. Oncol."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"1705","DOI":"10.1056\/NEJMoa070956","article-title":"Cisplatin and fluorouracil alone or with docetaxel in head and neck cancer","volume":"357","author":"Posner","year":"2007","journal-title":"N. Engl. J. Med."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"1695","DOI":"10.1056\/NEJMoa071028","article-title":"Cisplatin, fluorouracil, and docetaxel in unresectable head and neck cancer","volume":"357","author":"Vermorken","year":"2007","journal-title":"N. Engl. J. Med."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"1173","DOI":"10.1038\/sj.bjc.6605860","article-title":"Short-term health-related quality of life and symptom control with docetaxel, cisplatin, 5-fluorouracil and cisplatin (TPF), 5-fluorouracil (PF) for induction in unresectable locoregionally advanced head and neck cancer patients (EORTC 24971\/TAX 323)","volume":"103","author":"Mauer","year":"2010","journal-title":"Br. J. Cancer"},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"1825","DOI":"10.1093\/annonc\/mdr545","article-title":"Adding docetaxel to cisplatin and fluorouracil in patients with unresectable head and neck cancer: A cost-utility analysis","volume":"23","author":"Liberato","year":"2012","journal-title":"Ann. Oncol."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"37297","DOI":"10.18632\/oncotarget.8934","article-title":"Neoadjuvant modified TPF (docetaxel, cisplatin, fluorouracil) for patients unfit to standard TPF in locally advanced head and neck squamous cell carcinoma: A study of 48 patients","volume":"7","author":"Fayette","year":"2016","journal-title":"Oncotarget"},{"key":"ref_15","doi-asserted-by":"crossref","unstructured":"Dietz, A., Wichmann, G., Flentje, M., Hagen, R., Koelbl, O., Schreiber, F., Schilling, V., Maschmeyer, G., Schroeder, U., and Sittel, C. (2016). Final results of the randomized phase II DeLOS-II trial: Induction chemotherapy (IC) followed by radiotherapy (R) vs. cetuximab (E) plus IC and R for functional larynx preservation in resectable laryngeal and hypopharyngeal cancer (LHSCC). J. Clin. Oncol., 34.","DOI":"10.1200\/JCO.2016.34.15_suppl.6025"},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"1119","DOI":"10.1634\/theoncologist.2015-0208","article-title":"A randomized, multicenter, phase II study of cetuximab with docetaxel and cisplatin as induction chemotherapy in unresectable, locally advanced head and neck cancer","volume":"20","author":"Lee","year":"2015","journal-title":"Oncologist"},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"21","DOI":"10.1016\/j.ijrobp.2016.04.030","article-title":"Final results of a randomized phase 2 trial investigating the addition of cetuximab to induction chemotherapy and accelerated or hyperfractionated chemoradiation for locoregionally advanced head and neck cancer","volume":"96","author":"Seiwert","year":"2016","journal-title":"Int. J. Radiat. Oncol. Biol. Phys."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"5294","DOI":"10.1200\/JCO.2010.30.6423","article-title":"Induction docetaxel, cisplatin, and cetuximab followed by concurrent radiotherapy, cisplatin, and cetuximab and maintenance cetuximab in patients with locally advanced head and neck cancer","volume":"28","author":"Argiris","year":"2010","journal-title":"J. Clin. Oncol."},{"key":"ref_19","first-page":"29","article-title":"Induction chemotherapy before surgery for unresectable head and neck cancer","volume":"12","author":"Schmaltz","year":"2016","journal-title":"B-ENT"},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"721","DOI":"10.1002\/cam4.408","article-title":"Induction therapy with cetuxi- mab plus docetaxel, cisplatin, and 5-fluorouracil (ETPF) in patients with resectable nonmetastatic stage III or IV squamous cell carcinoma of the oropharynx. A GERCOR phase II ECHO-07 study","volume":"4","author":"Chibaudel","year":"2015","journal-title":"Cancer Med."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"289","DOI":"10.1016\/j.ijrobp.2015.10.019","article-title":"A phase 2 open label, single-arm trial to evaluate the combination of cetuximab plus taxotere, cisplatin, and 5-flurouracil as an induction regimen in patients with unresectable squamous cell carcinoma of the head and neck","volume":"94","author":"Mesia","year":"2016","journal-title":"Int. J. Radiat. Oncol. Biol. Phys."},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"1917","DOI":"10.1093\/annonc\/mdx202","article-title":"A two-arm multicenter phase II trial of one cycle chemoselection split-dose docetaxel, cisplatin and 5-fluorouracil (TPF) induction chemotherapy before two cycles of split TPF followed by curative surgery combined with postoperative radiotherapy in patients with locally advanced oral and oropharyngeal squamous cell cancer (TISOC-1)","volume":"28","author":"Inhestern","year":"2017","journal-title":"Ann. Oncol."},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"853","DOI":"10.1200\/JCO.2012.42.3988","article-title":"Induction chemotherapy followed by either chemoradiotherapy or bioradiotherapy for larynx preservation: The TREMPLIN randomized phase II study","volume":"31","author":"Lefebvre","year":"2013","journal-title":"J. Clin. Oncol."},{"key":"ref_24","doi-asserted-by":"crossref","unstructured":"Hitt, R., Mesia, R., Grau, J.J., Iglesias, L., Barco, E.D., Lozano, A., Trufero, J.M., Giron, C.G., Martin, A.L., and Hernandez, J.J.C. (2016). Randomized phase III trial of induction chemotherapy (ICT) with docetaxel-cisplatin-5fluorouracil (DCF) followed by cisplatin-radiotherapy (CRT) or cetuximab-radiotherapy (CetRT) in patients (pts) with locally advanced unresectable head and neck cancer (LAUHNC). J. Clin. Oncol., 34.","DOI":"10.1200\/JCO.2016.34.15_suppl.6001"},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"216","DOI":"10.1093\/annonc\/mdt461","article-title":"A randomized phase III trial comparing induction chemotherapy followed by chemoradiotherapy versus chemoradiotherapy alone as treatment of unresectable head and neck cancer","volume":"25","author":"Hitt","year":"2014","journal-title":"Ann. Oncol."},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"257","DOI":"10.1016\/S1470-2045(13)70011-1","article-title":"Induction chemotherapy followed by concurrent chemoradiotherapy (sequential chemoradiotherapy) versus concurrent chemoradiotherapy alone in locally advanced head and neck cancer (PARADIGM): A randomized phase 3 trial","volume":"14","author":"Haddad","year":"2013","journal-title":"Lancet Oncol."},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"3077","DOI":"10.1200\/JCO.2017.76.2591","article-title":"Induction Chemotherapy Followed by Cetuximab Radiotherapy Is Not Superior to Concurrent Chemoradiotherapy for Head and Neck Carcinomas: Results of the GORTEC 2007-02 Phase III Randomized Trial","volume":"36","author":"Geoffrois","year":"2018","journal-title":"J. Clin. Oncol."},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"2206","DOI":"10.1093\/annonc\/mdx299","article-title":"Induction TPF followed by concomitant treatment versus concomitant treatment alone in locally advanced Head and Neck Cancer. A phase II-III trial","volume":"28","author":"Ghi","year":"2017","journal-title":"Ann. Oncol."},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"2735","DOI":"10.1200\/JCO.2013.54.6309","article-title":"Phase III randomized trial of induction chemotherapy in patients with N2 or N3 locally advanced head and neck cancer","volume":"32","author":"Cohen","year":"2014","journal-title":"J. Clin. Oncol."},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"455","DOI":"10.1007\/s10147-014-0749-4","article-title":"Efficacy and feasibility of docetaxel, cisplatin, and 5-fluorouracil induction chemotherapy for locally advanced head and neck squamous cell carcinoma classified as clinical nodal stage N2c, N3, or N2b with supraclavicular lymph node metastases","volume":"20","author":"Izawa","year":"2015","journal-title":"Int. J. Clin. Oncol."},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"46","DOI":"10.4143\/crt.2013.212","article-title":"Analysis of the prognostic factors for distant metastasis after induction chemotherapy followed by concurrent chemoradiotherapy for head and neck cancer","volume":"47","author":"Kim","year":"1970","journal-title":"Cancer Res. Treat."},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"1215","DOI":"10.1093\/annonc\/mdu120","article-title":"GDF15 is a potential predictive biomarker for TPF induction chemotherapy and promotes tumorigenesis and progression in oral squamous cell carcinoma","volume":"25","author":"Yang","year":"2014","journal-title":"Ann. Oncol."},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"413","DOI":"10.1016\/j.oraloncology.2012.12.011","article-title":"Tp53 status as guide for the management of ethmoid sinus intestinal type adenocarcinoma","volume":"49","author":"Bossi","year":"2013","journal-title":"Oral Oncol."},{"key":"ref_34","doi-asserted-by":"crossref","unstructured":"The Department of Veterans Affairs Laryngeal Cancer Study Group (1991). Induction chemotherapy plus radiation compared with surgery plus radiation in patients with advanced laryngeal cancer. N. Engl. J. Med., 324, 1685\u20131690.","DOI":"10.1056\/NEJM199106133242402"},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"142","DOI":"10.1093\/jnci\/djn460","article-title":"Phase 3 randomized trial on larynx preservation comparing sequential vs alternating chemotherapy and radiotherapy","volume":"101","author":"Lefebvre","year":"2009","journal-title":"J. Natl. Cancer Inst."},{"key":"ref_36","doi-asserted-by":"crossref","unstructured":"Janoray, G., Pointreau, Y., Garaud, P., Chapet, S., Alfonsi, M., Sire, C., Tuchais, C., and Calais, G. (2015). Long-term results of GORTEC 2000-01: A multicentric randomized phase III trial of induction chemotherapy with cisplatin plus 5-fluorouracil, with or without docetaxel, for larynx preservation. J. Clin. Oncol.","DOI":"10.1093\/jnci\/djv368"},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"845","DOI":"10.1200\/JCO.2012.43.6097","article-title":"Long-term results of RTOG 91-11: A comparison of three nonsurgical treatment strategies to preserve the larynx in patients with locally advanced larynx cancer","volume":"31","author":"Forastiere","year":"2013","journal-title":"J. Clin. Oncol."},{"key":"ref_38","doi-asserted-by":"crossref","first-page":"4294","DOI":"10.1200\/JCO.2011.36.4596","article-title":"Human papillomavirus and rising oropharyngeal cancer incidence in the United States","volume":"29","author":"Chaturvedi","year":"2011","journal-title":"J. Clin. Oncol."},{"key":"ref_39","doi-asserted-by":"crossref","unstructured":"Seiwert, T., Melotek, J.M., Foster, C.C., Blair, E.A., Karrison, T.G., Agrawal, N., Portugal, L., Gooi, Z., Stenson, K.M., and Brisson, R.J. (2018, January 15\u201317). OPTIMA\u2014A phase II trial of induction chemotherapy response-stratified RT dose and volume de-escalation for HPV+ oropharynx cancer: Efficacy, toxicity, and HPV subtype analysis. Proceedings of the 2018 Multidisciplinary Head and Neck Cancer Symposium, Scottsdale, AZ, USA. Abstract 5.","DOI":"10.1016\/j.ijrobp.2017.12.025"},{"key":"ref_40","unstructured":"National Cancer Institute (2012). The Quarterback Trial."},{"key":"ref_41","unstructured":"Mehanna, H., Kong, A., and Hartley, A. (2018, January 19\u201323). Cetuximab versus cisplatin in patients with HPV-positive, low risk oropharyngeal cancer, receiving radical radiotherapy. Proceedings of the ESMO 2018 Congress, Munich, Germany."}],"container-title":["Cancers"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2072-6694\/11\/1\/15\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,11]],"date-time":"2025-10-11T15:35:41Z","timestamp":1760196941000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2072-6694\/11\/1\/15"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2018,12,22]]},"references-count":41,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2019,1]]}},"alternative-id":["cancers11010015"],"URL":"https:\/\/doi.org\/10.3390\/cancers11010015","relation":{},"ISSN":["2072-6694"],"issn-type":[{"value":"2072-6694","type":"electronic"}],"subject":[],"published":{"date-parts":[[2018,12,22]]}}}