Universitätsklinikum Frankfurt am Main R. Knecht Universitätsklinikum Frankfurt am Main R. Knecht...

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Universitätsklinikum Universitätsklinikum Frankfurt am Main Frankfurt am Main R. Knecht R. Knecht Induction chemotherapy TPF Induction chemotherapy TPF 3 Cycles 3 Cycles Docetaxel 75mg/m Docetaxel 75mg/m 2 d1 d1 Cisplatin 100mg/m Cisplatin 100mg/m 2 2 d1 d1 5-FU 1000mg/m 5-FU 1000mg/m 2 2 d1-4 d1-4 Radiochemotherapy Radiochemotherapy 70 Gy + Cisplatin 100 mg /m 70 Gy + Cisplatin 100 mg /m 2 d1, 22, 43 d1, 22, 43 Laryngoprotect-Study Laryngoprotect-Study R. Knecht et al. R. Knecht et al.

Transcript of Universitätsklinikum Frankfurt am Main R. Knecht Universitätsklinikum Frankfurt am Main R. Knecht...

Page 1: Universitätsklinikum Frankfurt am Main R. Knecht Universitätsklinikum Frankfurt am Main R. Knecht Induction chemotherapy TPF 3 Cycles Docetaxel 75mg/m.

UniversitätsklinikumUniversitätsklinikumFrankfurt am MainFrankfurt am MainR. KnechtR. Knecht

UniversitätsklinikumUniversitätsklinikumFrankfurt am MainFrankfurt am MainR. KnechtR. Knecht

Induction chemotherapy TPF Induction chemotherapy TPF 3 Cycles3 Cycles

Docetaxel 75mg/mDocetaxel 75mg/m22 d1 d1

Cisplatin 100mg/mCisplatin 100mg/m2 2 d1d1

5-FU 1000mg/m5-FU 1000mg/m2 2 d1-4d1-4

Induction chemotherapy TPF Induction chemotherapy TPF 3 Cycles3 Cycles

Docetaxel 75mg/mDocetaxel 75mg/m22 d1 d1

Cisplatin 100mg/mCisplatin 100mg/m2 2 d1d1

5-FU 1000mg/m5-FU 1000mg/m2 2 d1-4d1-4

RadiochemotherapyRadiochemotherapy 70 Gy + Cisplatin 100 mg /m70 Gy + Cisplatin 100 mg /m22 d1, 22, 43 d1, 22, 43

RadiochemotherapyRadiochemotherapy 70 Gy + Cisplatin 100 mg /m70 Gy + Cisplatin 100 mg /m22 d1, 22, 43 d1, 22, 43

Laryngoprotect-StudyLaryngoprotect-StudyR. Knecht et al.R. Knecht et al.

Laryngoprotect-StudyLaryngoprotect-StudyR. Knecht et al.R. Knecht et al.

Page 2: Universitätsklinikum Frankfurt am Main R. Knecht Universitätsklinikum Frankfurt am Main R. Knecht Induction chemotherapy TPF 3 Cycles Docetaxel 75mg/m.

UniversitätsklinikumUniversitätsklinikumFrankfurt am MainFrankfurt am MainR. KnechtR. Knecht

UniversitätsklinikumUniversitätsklinikumFrankfurt am MainFrankfurt am MainR. KnechtR. Knecht

Regions and stages in %Regions and stages in %Regions and stages in %Regions and stages in %

55%55%

24%24%

21%21%

T/NT/N

4

4

13

21

2

3

3

8

NN11 NN22 NN33

2525

3434

2525

3434

2

3

-

5

TT22

TT33

TT44

15

35

50

100

NN00

Stage IIStage II Stage IIIStage III Stage IVStage IV

7

66

n=103n=103

Page 3: Universitätsklinikum Frankfurt am Main R. Knecht Universitätsklinikum Frankfurt am Main R. Knecht Induction chemotherapy TPF 3 Cycles Docetaxel 75mg/m.

UniversitätsklinikumUniversitätsklinikumFrankfurt am MainFrankfurt am MainR. KnechtR. Knecht

UniversitätsklinikumUniversitätsklinikumFrankfurt am MainFrankfurt am MainR. KnechtR. Knecht

Toxicity Toxicity (WHO Grad III / IV)(WHO Grad III / IV)Toxicity Toxicity (WHO Grad III / IV)(WHO Grad III / IV)

RenalRenal 25%25%

Afebrile Neutropenia Afebrile Neutropenia 95%95%

Nausea/VomitingNausea/Vomiting 25%25%

Mucositis Mucositis 10%10%

Sensory NeuropathySensory Neuropathy 10%10%

4%4%

47%47%

20%20%

43%43%

5%5%

InductionInductionchemotherapychemotherapy

Radio-Radio-chemotherapychemotherapy

Page 4: Universitätsklinikum Frankfurt am Main R. Knecht Universitätsklinikum Frankfurt am Main R. Knecht Induction chemotherapy TPF 3 Cycles Docetaxel 75mg/m.

UniversitätsklinikumUniversitätsklinikumFrankfurt am MainFrankfurt am MainR. KnechtR. Knecht

UniversitätsklinikumUniversitätsklinikumFrankfurt am MainFrankfurt am MainR. KnechtR. Knecht

ResultsResultsafter TPF - Polychemotherapy (3 Cycles)after TPF - Polychemotherapy (3 Cycles)

ResultsResultsafter TPF - Polychemotherapy (3 Cycles)after TPF - Polychemotherapy (3 Cycles)

SupraglottisSupraglottis

GlottisGlottis

Hypopharynx Hypopharynx

SupraglottisSupraglottis

GlottisGlottis

Hypopharynx Hypopharynx

RRRRRRRR

76%76%

73%73%

92%92%

79%79%

76%76%

73%73%

92%92%

79%79%

41%41%

53%53%

54%54%

47%47%

41%41%

53%53%

54%54%

47%47%

CRCRCRCR

Page 5: Universitätsklinikum Frankfurt am Main R. Knecht Universitätsklinikum Frankfurt am Main R. Knecht Induction chemotherapy TPF 3 Cycles Docetaxel 75mg/m.

UniversitätsklinikumUniversitätsklinikumFrankfurt am MainFrankfurt am MainR. KnechtR. Knecht

UniversitätsklinikumUniversitätsklinikumFrankfurt am MainFrankfurt am MainR. KnechtR. Knecht

postpost

ResultsResultsafter TPF - Polychemotherapy (3 Cycles)after TPF - Polychemotherapy (3 Cycles)

ResultsResultsafter TPF - Polychemotherapy (3 Cycles)after TPF - Polychemotherapy (3 Cycles)

prae

S. A., T3N3M0

Page 6: Universitätsklinikum Frankfurt am Main R. Knecht Universitätsklinikum Frankfurt am Main R. Knecht Induction chemotherapy TPF 3 Cycles Docetaxel 75mg/m.

UniversitätsklinikumUniversitätsklinikumFrankfurt am MainFrankfurt am MainR. KnechtR. Knecht

UniversitätsklinikumUniversitätsklinikumFrankfurt am MainFrankfurt am MainR. KnechtR. Knecht

postprae

B. W., T2N1M0

ResultsResultsafter TPF - Polychemotherapy (3 Cycles)after TPF - Polychemotherapy (3 Cycles)

ResultsResultsafter TPF - Polychemotherapy (3 Cycles)after TPF - Polychemotherapy (3 Cycles)

Page 7: Universitätsklinikum Frankfurt am Main R. Knecht Universitätsklinikum Frankfurt am Main R. Knecht Induction chemotherapy TPF 3 Cycles Docetaxel 75mg/m.

UniversitätsklinikumUniversitätsklinikumFrankfurt am MainFrankfurt am MainR. KnechtR. Knecht

UniversitätsklinikumUniversitätsklinikumFrankfurt am MainFrankfurt am MainR. KnechtR. Knecht

prae

B. W., T2N1M0post

ResultsResultsafter TPF - Polychemotherapy(3 Cycles)after TPF - Polychemotherapy(3 Cycles)

ResultsResultsafter TPF - Polychemotherapy(3 Cycles)after TPF - Polychemotherapy(3 Cycles)

Page 8: Universitätsklinikum Frankfurt am Main R. Knecht Universitätsklinikum Frankfurt am Main R. Knecht Induction chemotherapy TPF 3 Cycles Docetaxel 75mg/m.

UniversitätsklinikumUniversitätsklinikumFrankfurt am MainFrankfurt am MainR. KnechtR. Knecht

UniversitätsklinikumUniversitätsklinikumFrankfurt am MainFrankfurt am MainR. KnechtR. Knecht

postpostpraeprae

M. B., T2N1M0M. B., T2N1M0

ResultsResultsafter TPF - Polychemotherapy (3 Cycles)after TPF - Polychemotherapy (3 Cycles)

ResultsResultsafter TPF - Polychemotherapy (3 Cycles)after TPF - Polychemotherapy (3 Cycles)

Page 9: Universitätsklinikum Frankfurt am Main R. Knecht Universitätsklinikum Frankfurt am Main R. Knecht Induction chemotherapy TPF 3 Cycles Docetaxel 75mg/m.

UniversitätsklinikumUniversitätsklinikumFrankfurt am MainFrankfurt am MainR. KnechtR. Knecht

UniversitätsklinikumUniversitätsklinikumFrankfurt am MainFrankfurt am MainR. KnechtR. Knecht

Zur Anzeige wird der QuickTime™ Dekompressor „YUV420 codec“

benötigt.

Zur Anzeige wird der QuickTime™ Dekompressor „YUV420 codec“

benötigt.Zur Anzeige wird der QuickTime™ Dekompressor „YUV420 codec“

benötigt.

Zur Anzeige wird der QuickTime™ Dekompressor „YUV420 codec“

benötigt.

postpostprae prae

B. H., T2N2bM0B. H., T2N2bM0

ResultsResultsafter TPF - Polychemotherapy (3 Cycles)after TPF - Polychemotherapy (3 Cycles)

ResultsResultsafter TPF - Polychemotherapy (3 Cycles)after TPF - Polychemotherapy (3 Cycles)

Page 10: Universitätsklinikum Frankfurt am Main R. Knecht Universitätsklinikum Frankfurt am Main R. Knecht Induction chemotherapy TPF 3 Cycles Docetaxel 75mg/m.

UniversitätsklinikumUniversitätsklinikumFrankfurt am MainFrankfurt am MainR. KnechtR. Knecht

UniversitätsklinikumUniversitätsklinikumFrankfurt am MainFrankfurt am MainR. KnechtR. Knecht

postpost

Zur Anzeige wird der QuickTime™ Dekompressor „YUV420 codec“

benötigt.

Zur Anzeige wird der QuickTime™ Dekompressor „YUV420 codec“

benötigt.Zur Anzeige wird der QuickTime™ Dekompressor „YUV420 codec“

benötigt.

Zur Anzeige wird der QuickTime™ Dekompressor „YUV420 codec“

benötigt.

prae prae

G. H., T2N2bM0G. H., T2N2bM0

ResultsResultsafter TPF - Polychemotherapy (3 Cycles)after TPF - Polychemotherapy (3 Cycles)

ResultsResultsafter TPF - Polychemotherapy (3 Cycles)after TPF - Polychemotherapy (3 Cycles)

Page 11: Universitätsklinikum Frankfurt am Main R. Knecht Universitätsklinikum Frankfurt am Main R. Knecht Induction chemotherapy TPF 3 Cycles Docetaxel 75mg/m.

UniversitätsklinikumUniversitätsklinikumFrankfurt am MainFrankfurt am MainR. KnechtR. Knecht

UniversitätsklinikumUniversitätsklinikumFrankfurt am MainFrankfurt am MainR. KnechtR. Knecht

postpost

Zur Anzeige wird der QuickTime™ Dekompressor „YUV420 codec“

benötigt.

Zur Anzeige wird der QuickTime™ Dekompressor „YUV420 codec“

benötigt.Zur Anzeige wird der QuickTime™ Dekompressor „YUV420 codec“

benötigt.

Zur Anzeige wird der QuickTime™ Dekompressor „YUV420 codec“

benötigt.

prae prae

J. H., T2N2bM0J. H., T2N2bM0

ResultsResultsafter TPF - Polychemotherapy (3 Cycles)after TPF - Polychemotherapy (3 Cycles)

ResultsResultsafter TPF - Polychemotherapy (3 Cycles)after TPF - Polychemotherapy (3 Cycles)

Page 12: Universitätsklinikum Frankfurt am Main R. Knecht Universitätsklinikum Frankfurt am Main R. Knecht Induction chemotherapy TPF 3 Cycles Docetaxel 75mg/m.

UniversitätsklinikumUniversitätsklinikumFrankfurt am MainFrankfurt am MainR. KnechtR. Knecht

UniversitätsklinikumUniversitätsklinikumFrankfurt am MainFrankfurt am MainR. KnechtR. Knecht

Induction chemotherapy Induction chemotherapy 3 Cycles3 Cycles

Cisplatin (100mg/mCisplatin (100mg/m22) ) 5 Fluorouracil (4000mg/m5 Fluorouracil (4000mg/m22))

Docetaxel (75mg/mDocetaxel (75mg/m22))

Induction chemotherapy Induction chemotherapy 3 Cycles3 Cycles

Cisplatin (100mg/mCisplatin (100mg/m22) ) 5 Fluorouracil (4000mg/m5 Fluorouracil (4000mg/m22))

Docetaxel (75mg/mDocetaxel (75mg/m22))

Laryngoprotect n = 103

RadiochemotherapyRadiochemotherapy (70Gy)

Cisplatin (3x 100mg/m2)

RadiochemotherapyRadiochemotherapy (70Gy)

Cisplatin (3x 100mg/m2)

74% 74% 75%75%

2% 2% 93%93%

74% 74% 75%75%

2% 2% 93%93%

Larynx preservationLarynx preservationDisease free surv.Disease free surv.Distant metastasisDistant metastasisSurvivalSurvival

Larynx preservationLarynx preservationDisease free surv.Disease free surv.Distant metastasisDistant metastasisSurvivalSurvival

2 years

ResultsResultsHypopharynxHypopharynxResultsResultsHypopharynxHypopharynx

Knecht R . et al. Knecht R . et al. (2004)(2004) JOURNAL OF CLINICAL ONCOLOGY 22 (14): 502S-502S 5559JOURNAL OF CLINICAL ONCOLOGY 22 (14): 502S-502S 5559

Page 13: Universitätsklinikum Frankfurt am Main R. Knecht Universitätsklinikum Frankfurt am Main R. Knecht Induction chemotherapy TPF 3 Cycles Docetaxel 75mg/m.

UniversitätsklinikumUniversitätsklinikumFrankfurt am MainFrankfurt am MainR. KnechtR. Knecht

UniversitätsklinikumUniversitätsklinikumFrankfurt am MainFrankfurt am MainR. KnechtR. Knecht

Induktion chemotherapy Induktion chemotherapy 3 Cycles3 Cycles

Cisplatin (100mg/mCisplatin (100mg/m22) ) 5 Fluorouracil (4000mg/m5 Fluorouracil (4000mg/m22))

Docetaxel (75mg/mDocetaxel (75mg/m22))

Induktion chemotherapy Induktion chemotherapy 3 Cycles3 Cycles

Cisplatin (100mg/mCisplatin (100mg/m22) ) 5 Fluorouracil (4000mg/m5 Fluorouracil (4000mg/m22))

Docetaxel (75mg/mDocetaxel (75mg/m22))

2 years

Laryngoprotect n = 103Laryngoprotect n = 103Laryngoprotect n = 103Laryngoprotect n = 103

91% 91% 85%85%

0% 0% 94%94%

91% 91% 85%85%

0% 0% 94%94%

Larynx preservationLarynx preservationDisease free surv.Disease free surv.Distant metastasisDistant metastasisSurvivalSurvival

Larynx preservationLarynx preservationDisease free surv.Disease free surv.Distant metastasisDistant metastasisSurvivalSurvival

RadiochemotherapyRadiochemotherapy (70Gy)

Cisplatin (3x 100mg/m2)

RadiochemotherapyRadiochemotherapy (70Gy)

Cisplatin (3x 100mg/m2)

ResultsResultsLarynxLarynx

ResultsResultsLarynxLarynx

Knecht R . et al. Knecht R . et al. (2004)(2004) JOURNAL OF CLINICAL ONCOLOGY 22 (14): 502S-502S 5559JOURNAL OF CLINICAL ONCOLOGY 22 (14): 502S-502S 5559

Page 14: Universitätsklinikum Frankfurt am Main R. Knecht Universitätsklinikum Frankfurt am Main R. Knecht Induction chemotherapy TPF 3 Cycles Docetaxel 75mg/m.

UniversitätsklinikumUniversitätsklinikumFrankfurt am MainFrankfurt am MainR. KnechtR. Knecht

UniversitätsklinikumUniversitätsklinikumFrankfurt am MainFrankfurt am MainR. KnechtR. Knecht

Induction chemotherapy Induction chemotherapy 3 Cycles3 Cycles

Cisplatin (100mg/mCisplatin (100mg/m22) ) 5 Fluorouracil (4000mg/m5 Fluorouracil (4000mg/m22))

Docetaxel (75mg/mDocetaxel (75mg/m22))

Induction chemotherapy Induction chemotherapy 3 Cycles3 Cycles

Cisplatin (100mg/mCisplatin (100mg/m22) ) 5 Fluorouracil (4000mg/m5 Fluorouracil (4000mg/m22))

Docetaxel (75mg/mDocetaxel (75mg/m22))

2 years

Laryngoprotect n = 103Laryngoprotect n = 103Laryngoprotect n = 103Laryngoprotect n = 103

91% 91% 85%85%

0% 0% 94%94%

91% 91% 85%85%

0% 0% 94%94%

Larynx preservationLarynx preservationDisease free surv.Disease free surv.Distant metastasisDistant metastasisSurvivalSurvival

Larynx preservationLarynx preservationDisease free surv.Disease free surv.Distant metastasisDistant metastasisSurvivalSurvival

RadiochemotherapyRadiochemotherapy (70Gy)

Cisplatin (3x 100mg/m2)

RadiochemotherapyRadiochemotherapy (70Gy)

Cisplatin (3x 100mg/m2)

ResultsResultsLarynxLarynx

ResultsResultsLarynxLarynx

RadiochemotherapyRadiochemotherapy (70Gy)

Cisplatin (3x 100mg/m2)

RadiochemotherapyRadiochemotherapy (70Gy)

Cisplatin (3x 100mg/m2)

RTOG 91-11 n = 172

88% 88% 61%61%

8% 8% 74%74%

88% 88% 61%61%

8% 8% 74%74%

Knecht R . et al. Knecht R . et al. (2004)(2004) JOURNAL OF CLINICAL ONCOLOGY 22 (14): 502S-502S 5559JOURNAL OF CLINICAL ONCOLOGY 22 (14): 502S-502S 5559

Page 15: Universitätsklinikum Frankfurt am Main R. Knecht Universitätsklinikum Frankfurt am Main R. Knecht Induction chemotherapy TPF 3 Cycles Docetaxel 75mg/m.

UniversitätsklinikumUniversitätsklinikumFrankfurt am MainFrankfurt am MainR. KnechtR. Knecht

UniversitätsklinikumUniversitätsklinikumFrankfurt am MainFrankfurt am MainR. KnechtR. Knecht

Laryngoprotect 2Laryngoprotect 2Laryngoprotect 2Laryngoprotect 2

RadiochemotherapyRadiochemotherapy (70Gy)

Cisplatin (3x 100mg/m2)

RadiochemotherapyRadiochemotherapy (70Gy)

Cisplatin (3x 100mg/m2)

Induction chemotherapy Induction chemotherapy 3 Cycles3 Cycles

Cisplatin (100mg/mCisplatin (100mg/m22) ) 5 Fluorouracil (4000mg/m5 Fluorouracil (4000mg/m22))

Docetaxel (75mg/mDocetaxel (75mg/m22))

Induction chemotherapy Induction chemotherapy 3 Cycles3 Cycles

Cisplatin (100mg/mCisplatin (100mg/m22) ) 5 Fluorouracil (4000mg/m5 Fluorouracil (4000mg/m22))

Docetaxel (75mg/mDocetaxel (75mg/m22))

RadiochemotherapyRadiochemotherapy (70Gy)

Cisplatin (3x 100mg/m2)

RadiochemotherapyRadiochemotherapy (70Gy)

Cisplatin (3x 100mg/m2)

22

Page 16: Universitätsklinikum Frankfurt am Main R. Knecht Universitätsklinikum Frankfurt am Main R. Knecht Induction chemotherapy TPF 3 Cycles Docetaxel 75mg/m.

UniversitätsklinikumUniversitätsklinikumFrankfurt am MainFrankfurt am MainR. KnechtR. Knecht

UniversitätsklinikumUniversitätsklinikumFrankfurt am MainFrankfurt am MainR. KnechtR. Knecht

Induction chemotherapy TPF 3Cycles Docetaxel 75mg/m2 d1Cisplatin 100mg/m2 d15-FU 1000mg/m2 d1-4

Induction chemotherapy TPF 3Cycles Docetaxel 75mg/m2 d1Cisplatin 100mg/m2 d15-FU 1000mg/m2 d1-4

Radiochemotherapy Radiochemotherapy 70 Gy (2 Gy/d; 5x/week) Cisplatin, (300mg/m70 Gy (2 Gy/d; 5x/week) Cisplatin, (300mg/m2 2 total)total)

Radiochemotherapy Radiochemotherapy 70 Gy (2 Gy/d; 5x/week) Cisplatin, (300mg/m70 Gy (2 Gy/d; 5x/week) Cisplatin, (300mg/m2 2 total)total)

Induction chemotherapy TPF 3Cycles Docetaxel 75mg/m2 d1Cisplatin 100mg/m2 d15-FU 1000mg/m2 d1-4

Cetuximab (400 mg d1; 250mg ab d8 wöchtl)(400 mg d1; 250mg ab d8 wöchtl)

Induction chemotherapy TPF 3Cycles Docetaxel 75mg/m2 d1Cisplatin 100mg/m2 d15-FU 1000mg/m2 d1-4

Cetuximab (400 mg d1; 250mg ab d8 wöchtl)(400 mg d1; 250mg ab d8 wöchtl)

International principal investigator: R. KnechtInternational principal investigator: R. KnechtInternational principal investigator: R. KnechtInternational principal investigator: R. Knecht

Stage III/IVStage III/IVStage III/IVStage III/IV

EGFR-Antibody EGFR-Antibody Neoadjuvant Primary TherapyNeoadjuvant Primary Therapy EGFR-Antibody EGFR-Antibody

Neoadjuvant Primary TherapyNeoadjuvant Primary Therapy