title: Concurrent chemoradiation with daily low dose cisplatin for advanced stage head and neck carcinoma.
abstract: OBJECTIVE
  To evaluate treatment results of concurrent chemoradiation with daily low dose cisplatin.
  
  
  METHODS
  121 patients with advanced stage HNSCC were treated with RT (35 x 2 Gy) and cisplatin (6 mg/m(2) i.v. x20, daily before RT). After 47 patients, the treatment protocol (Standard Group) was changed: Daily i.v. prehydration and accelerated RT were given to the subsequent 74 patients (Hydr-Ac-RT Group).
  
  
  RESULTS
  Mean follow-up was 29 months (range 7-62). More chemotherapy could be administered in the Hydr-Ac-RT Group (maximum no. of 20 cisplatin-infusions increased from 59% to 91% of patients, p=0.008), with less renal toxicity (p<0.001) and less hospital admissions (p<0.02). However, mucositis was more pronounced and tubefeeding more frequent in the Hydr-Ac-RT Group. The CR rate of the primary tumor increased from 74% (Standard Group) to 90% (Hydr-Ac-RT Group) (p=0.06), although this did not lead to an improvement in loco-regional control.
  
  
  CONCLUSIONS
  Concurrent chemoradiation with daily low dose cisplatin is feasible and effective for selected patients with advanced HNSCC. Although the addition of accelerated RT resulted in more mucositis and tubefeeding, the introduction of prehydration led to better compliance to therapy with more chemotherapy administered and less hospital admissions.
authors: Department of Radiotherapy, The Netherlands Cancer Institute/Antoni van Leeuwenhoek Hospital, Amsterdam, The Netherlands. f.hoebers@nki.nl
authors: Frank J P
authors: FJ
authors: Hoebers
authors: Wilma
authors: W
authors: Heemsbergen
authors: Alfons J M
authors: AJ
authors: Balm
authors: Mathilde
authors: M
authors: van Zanten
authors: Jan H
authors: JH
authors: Schornagel
authors: Coen R N
authors: CR
authors: Rasch
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002945:Cisplatin / Q000627:therapeutic use*; D003131:Combined Modality Therapy; D005260:Female; D006258:Head and Neck Neoplasms / Q000188:drug therapy / Q000473:pathology / Q000532:radiotherapy*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D010349:Patient Compliance; D016896:Treatment Outcome
chemical_list: D002945:Cisplatin