Toxicity of daily low dose cisplatin in radiochemotherapy for locally advanced head and neck cancer.
OBJECTIVE
To evaluate toxicity of radiochemotherapy schedule using daily-low-dose-cisplatin in radiochemotherapy of locally-advanced head-and-neck-cancer (HNSCC).


METHODS
From October 2003 to October 2006, 50 patients with HNSCC (stage III/IVA/IVB) were treated. In 32 patients, surgery and adjuvant radiotherapy(64 Gy), in 18 patients definitive radiotherapy(70 Gy) was performed. Low-dose-cisplatin was applied concomitantly (6 mg/m2/every radiotherapy-day).


RESULTS
Acute toxicity > or =grade 3 was observed in 22 patients (11 patients mucositis/dysphagia, 7 hematologic toxicity, 4 mucositis/dysphagia/hematologic toxicity). 90% of our patients received >80% of the planned cumulative chemotherapy dose, 94% the intended dose of radiotherapy. After median follow-up of 24.2 months, 3-year overall survival and loco-regional control rates were 67.1 and 78%. During follow-up, chronic toxicity > or =grade 3 (xerostomia, subcutaneous fibrosis, or lymphedema) was observed in nine patients.


CONCLUSIONS
We found chemoradiation with daily-low-dose-cisplatin to be feasible with advantage of low acute and chronic toxicity. Therefore, use of low-dose-cisplatin should be evaluated in future clinical trials.
Wolff
Hendrik Andreas
HA
Department of Radiotherapy and Radiooncology, Universitätsmedizin Göttingen, Robert-Koch-Strasse 40, 37075, Göttingen, Germany. drhawolff@googlemail.com
Overbeck
Tobias
T
Roedel
Ralph M
RM
Hermann
Robert M
RM
Herrmann
Markus K A
MK
Kertesz
Tereza
T
Vorwerk
Hilke
H
Hille
Andrea
A
Matthias
Christoph
C
Hess
Clemens F
CF
Christiansen
Hans
H
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002294:Carcinoma, Squamous Cell / Q000401:mortality / Q000473:pathology / Q000532:radiotherapy* / Q000601:surgery; D002945:Cisplatin / Q000008:administration & dosage* / Q000009:adverse effects*; D018450:Disease Progression; D004305:Dose-Response Relationship, Drug; D004334:Drug Administration Schedule; D064420:Drug-Related Side Effects and Adverse Reactions; D005260:Female; D005500:Follow-Up Studies; D006258:Head and Neck Neoplasms / Q000401:mortality / Q000473:pathology / Q000532:radiotherapy* / Q000601:surgery; D006801:Humans; D008297:Male; D008875:Middle Aged; D008991:Monitoring, Physiologic; D011838:Radiation-Sensitizing Agents / Q000008:administration & dosage / Q000009:adverse effects; D018714:Radiotherapy, Adjuvant; D016019:Survival Analysis
D011838:Radiation-Sensitizing Agents; D002945:Cisplatin