Has anybody tried the TPF protocol? My son has tonsil ca T4 N2b M0. The onco did TPF, but dosage is reduced to almost 50% on all 3 drugs. Just wondering if this will be cause for recurrence?

Was your son treated with anything besides the chemo?

I second that question, usually tpf is given as a starter with a follow up of radiation and chemo.

Yes, I really hope that radiation is scheduled, along with probably more chemo.
Was the TPF induction chemo?
Tammy

I had TPF alone, and is usually done in three cycles three weeks apart, as neoadjunt therapy before Chemoradiation. I could only do one week, and was hospitalized for 187 days. Sounds like an exception, but in one study 50% of patients are unable to complete the remainder of treatment or continue curative treatment because of the toxicities with this, which is either surgery, radiation or chemoradiation, and why it was and still is controversial, but it works. Chemo alone does not cure this cancer, it acts as a radiosensitizer, and can shrink tumors, although this induction chemo can eradicate all cancer, it does not last, and cancer usually returns in less than a year, mine did at 8 months.

The week dosage is usually 160mg Taxotere, 160mg Cisplatin and 1600mg 5-FU.

If other treatments, as mentioned, are done, it can be curative. If Chemo, like TPF Induction chemo, is used alone, probably not.

My son had TPF every 21 days for 6 cycles. The MD said it was induction chemo, however, when I go online to research, induction chemo is only 2 -3 cycles. He is now having chemo/RT 6 doses of low cisplatin every week for 6 weeks concurrent with IMRT.

Yes, radiation is ongoing with low dose cisplatin

My son had TPF every 21 days for 6 cycles, took him 4.5 months. CT done, tonsil ca is gone but there are lymph node residuals. He is having chemoradiation with low dose cisplatin for 6 weeks and 34 IMRT. He is having a hard time with cisplatin and thinking of stopping the chemo and just go on with the radiation.

The typical number of TPF cycles is three, six is unusual. Maybe that accounts for the reduced dosing and the doubled number of cycles. Obviously a call to the MO can clear this up.

An alternative to cisplatin is carboplatin and generally an accepted alternative in cases where toxicity and side effects are of concern.

Make certain to make an informed decision on altering recommended treatment protocols. The chemo-radiation therapy is very tough on nearly all. If at all, tough it out as you want to kill this thing and never want to see it again. A few weeks of suffering now is worth the peace of mind that you and your team are doing everything possible. Don

But it took him 4.5 months to finish that treatment and now he is having a hard time with the chemoradiation. There are times he would say he's had enough. My son is actually in an Asian country and the MD's are saying it does not matter whether the ca is HPV based, the treatment is still for SCC. The second MD also said that the first chemo was too long and treatment has been delayed. Thanks for your encouraging words, will make sure I send it to him and maybe change his mind before he says no more to cisplatin. I am going to tell him about the carboplatin, too.

TPF Induction chemo is controversial, and many do not go on to complete the full induction chemo cycles, and or Chemoradiation or is delayed due to its high toxicities, including mortalities, but is very effective in killing cancer. One study said as high as 50% did not complete it. I had TPF,and ony did 5 days of TPF IC, which put me in a hospital, and acute critcal care nursing home for 187 days, paralyzed me from the waist down, lost over 110lbs in a few weeks, blinded me, and had 3rd degree burns to the hands, face, inside mouth, esophagus, feet, from Steven Johnson Syndrome, and much more. My local doctors said I was given too much chemo. and many doctors who came to see me for my care, including the burn unit who had to debrige the wounds, and couldn't believe chemo did that. As a result, I was unable to continue further treatment for over a year, and as a result of that, I have had numerous recurrences (8), and still have side effects, 4 years later, which were much worse than radiation. If TPF does kill all the cancer, which it can, it is short term only, and is likely to return within a year, if no further curative treatment is not done, and that is surgery, radiation, Chemoradiation. Carboplatin is an alternate to Cisplatin, with less side effects. Mine returned 8 months later, and then had radiation alone, and so on.

God luck to your son.

Hi Paul,
After my son's chemo, CT scan revealed residual neck lymphnodes , size reduced from 5 to 3.2 and tonsil ca gone.
However the onco was not sure what to do next so he moved on to another team that suggested chemoradiation: 6 low dose cisplatin and 34 IMRT. After 2 cycles of cisplatin, he cannot do it anymore. He was nauseated all the time which continued to the present even without having chemo for 2 weeks already. The rad onco said it was not a side effect of RT. My son is not able to eat well and drink and the doc was not recommending peg tube because according to him, no one has ever put a pegtube when undergoing RT in the country where he lives.

Trilled to hear the chemo resolved the tumors. After the first round of TPF, there was visual reduction in size. After the second, more reduction. After the third round, it was gone and the CT/PET reported "near or complete resolution".

As we know, cancer can only be killed with radiation or removal. I underwent chemo-radiation after the TPF to ensure there was total annihilation of the cancer. I received carboplatin to reduce the side effects while still acting as a radio-sensitizer to the rads.

The RO is right, HNC rads rarely make people nauseated but very common side effect of chemo.

As to the PEG, it is side effects of rads that require one being put in. The damage to the throat from rads makes it for many impossible to eat orally.

The clinic which treated my brother insists a PEG be placed before radiation starts. They prefer people having the procedure when they are relatively well, rather than when they are unable to eat properly.

That is the normal course of treatment, as Don Foo did, after TPF Induction chemo, sequetional Chemoradiation, and is the only real cure in this type therapy, chemo is not. The two chemo's may be enough, many here could only do 2 out of 3 large bag Cisplatins also, and that was without IC or had their last weekly cisplatin stopped. The main thing is to finish radiation. chemo acts as a radiosebsitizer to make radiation work better, how much differs with the type of chemo from 2%-20%, maybe higher with other studies. As far as the peg, the nasal tube in an option, and often preferred during treatment, instead if surgery, so I don't know what the doctor is saying. Nausea can be a side effect of radiation. I did radiation alone, and had nausea, vomiting, although pain medications also had a role too. Some patients even have anticipatory nausea just entering the room, thinking about treatment, will make them sick.

Good luck.

They can put in a peg at anytime - the drs where he is are wrong. I had mine put in at week 2 of rads. It's a simple procedure that in no way is effected by what he's going through he will feel uncomfortable but he's already uncomfortable - he is mildly sedated they go in and put it in place via ultrasound. It takes no more than ten - 15 minutes some people have had it done even further into treatment. Or he can have a nasal gastric tube put in. He needs his nutrition and hydration to heal and fight this otherwise it's a very steep slippery slope he'll find himself on. However is his caregiver there has to fight for him. I had a friend who reacted the same to cisplatin. He was sick as a dog for 7 weeks. Lived with his head in a garbage pail. He sucked it up and insisted they give it to him. They threatened to stop the last one but he managed to keep enough food down that he didn't lose anymore weight (he lost 50 lbs total) not fun but it's in is best interest to push until he gets what he wants. What country is he in? Hugs