Toxicity of two cisplatin-based radiochemotherapy regimens for the treatment of patients with stage III/IV head and neck cancer.
BACKGROUND
This nonrandomized study compared 2 radiochemotherapy regimens for toxicity in 128 patients with stage III/IV head and neck cancer.


METHODS
Patients received conventionally fractionated radiotherapy. The total dose to primary tumor and involved lymph nodes did depend on preceding surgery. Patients received 66 to 70 Gy if surgery was not performed, 60 to 66 Gy after R0 resection, 66 Gy after R1 resection, and 70 to 72 Gy after R2 resection. Concurrent chemotherapy consisted of 3 courses cisplatin (100 mg/m(2)/d1,22,43) (group A, N = 61) or 2 courses cisplatin (20 mg/m(2)/d1-5 + 29-33)/5-fluorouracil (5-FU) (600 mg/m(2)/d1-5 + 29-33) (group B, N = 67).


RESULTS
Acute toxicity was more severe in group A, especially nausea/vomiting (p = .002), nephrotoxicity (p = .001), ototoxicity (p = .034), and hematotoxicity (p = .049). Forty-eight percent of group A and 10% of group B patients could not complete chemotherapy due to toxicity (p = .018). Late toxicity was similar (p = .99).


CONCLUSIONS
Two courses of fractionated cisplatin (20 mg/m(2)/d) and 5-FU were associated with significantly less acute toxicity than were 3 courses cisplatin (100 mg/m(2)/d).
Department of Radiation Oncology, University Hospital Schleswig-Holstein, Campus Luebeck, Luebeck, Germany. Rades.Dirk@gmx.net
Dirk
D
Rades
Fabian
F
Fehlauer
Mashid
M
Sheikh-Sarraf
Nadja
N
Kazic
Hiba
H
Basic
Robert
R
Poorter
Samer G
SG
Hakim
Steven E
SE
Schild
Juergen
J
Dunst
D000970:Antineoplastic Agents / Q000008:administration & dosage* / Q000009:adverse effects; D002945:Cisplatin / Q000008:administration & dosage* / Q000009:adverse effects; D003131:Combined Modality Therapy; D019583:Dose Fractionation, Radiation; D005260:Female; D005472:Fluorouracil / Q000008:administration & dosage* / Q000009:adverse effects; D006258:Head and Neck Neoplasms / Q000188:drug therapy* / Q000532:radiotherapy*; D006801:Humans; D008297:Male; D008875:Middle Aged
D000970:Antineoplastic Agents; D002945:Cisplatin; D005472:Fluorouracil