title: Concomitant low-dose cisplatin and three-dimensional conformal radiotherapy for locally advanced squamous cell carcinoma of the head and neck: Analysis of survival and toxicity.
abstract: BACKGROUND
  Our center sought to implement a simple chemoradiotherapy schedule for patients with locally advanced squamous cell carcinoma of the head and neck (SCCHN) with minimal toxicity to achieve rates of overall survival comparable to other schedules.
  
  
  METHODS
  The chemoradiotherapy schedule consisted of daily radiation to 70 Gy over 7 weeks with concurrent cisplatin 20 mg/m(2) during days 1 to 4 of weeks 1 and 5. Acute and late toxicities were recorded according to the Radiation Therapy Oncology Group (RTOG) and common toxicity criteria (CTC) grading. The overall, disease-specific, and locoregional recurrence-free survival were calculated using the STATA statistics package. Possible factors influencing these endpoints were analyzed.
  
  
  RESULTS
  Fifty-seven patients were treated, and 56 patients were evaluable for follow-up. Median follow-up of alive patients was 16.1 months. There was an 82% complete response rate to chemoradiotherapy. The 2-year Kaplan-Meier overall, disease-specific, and locoregional recurrence-free survival rates were 62%, 67%, and 63%. Acute grade 3 and 4 radiation toxicity was noted in 61% and 2%, respectively. Grade 3 or 4 hematologic toxicity was noted in 7% of patients. Factors influencing overall survival included: Karnofsky performance status, receiving more than 50% of planned chemotherapy, age, and initial hemoglobin level.
  
  
  CONCLUSIONS
  This regimen is tolerable and achieves overall survival and locoregional control rates comparable to other chemoradiotherapy schedules.
authors.affiliation: Department of Radiation Oncology, Tom Baker Cancer Centre, 1331 29 St NW, Calgary, AB, Canada. haroldl@cancerboard.ab.ca
authors.forename: Harold
authors.initials: H
authors.lastname: Lau
authors.forename: Sony
authors.initials: S
authors.lastname: Brar
authors.forename: Desiree
authors.initials: D
authors.lastname: Hao
authors.forename: Jack
authors.initials: J
authors.lastname: MacKinnon
authors.forename: Don
authors.initials: D
authors.lastname: Yee
authors.forename: Stefan
authors.initials: S
authors.lastname: Gluck
mesh_terms: D000367:Age Factors; D000368:Aged; D000970:Antineoplastic Agents / Q000008:administration & dosage*; D002294:Carcinoma, Squamous Cell / Q000401:mortality / Q000473:pathology / Q000628:therapy*; D002945:Cisplatin / Q000008:administration & dosage*; D018572:Disease-Free Survival; D004334:Drug Administration Schedule; D005260:Female; D005500:Follow-Up Studies; D006258:Head and Neck Neoplasms / Q000401:mortality / Q000473:pathology / Q000628:therapy*; D006454:Hemoglobins / Q000032:analysis; D006801:Humans; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local; D018714:Radiotherapy, Adjuvant; D020266:Radiotherapy, Conformal; D012189:Retrospective Studies; D016879:Salvage Therapy
chemical_list: D000970:Antineoplastic Agents; D006454:Hemoglobins; D002945:Cisplatin