title: Acute toxicity of three versus two courses of cisplatin for radiochemotherapy of locally advanced squamous cell carcinoma of the head and neck (SCCHN): a matched pair analysis.
abstract: This matched pair analysis compared the toxicity of two cisplatin-based radiochemotherapy regimens in patients with locally advanced (stages III or IV) squamous cell carcinoma of the head and neck (SCCHN). Two courses of fractionated cisplatin (20mg/m(2)/d1-5) given concurrently with radiotherapy are better tolerated than other common cisplatin-based regimens. However, in several countries, three courses of unfractionated cisplatin (100mg/m(2)/d1) is standard therapy. Three courses of fractionated cisplatin (20mg/m(2)/d1-5) is another option. In this prospective study, 10 consecutive patients with stage III/IV SCCHN received three courses of fractionated cisplatin (group A). These patients were matched (1:3) to 30 patients who received two courses of fractionated cisplatin (group B). The patients were matched for age, gender, performance status, tumor site, T-category, N-category, tumor stage, and surgery. At least seven factors should match between the matched patients. Because of severe acute toxicity, the planned chemotherapy could not be completed in 90% of group A and 13% of group B patients, respectively (p=0.001). At least one grade >or= 3 toxicity occurred in 90% of group A and 20% of group B patients, respectively (p=0.005). Two courses of fractionated cisplatin appeared much better tolerated than three courses of fractionated cisplatin.
authors.affiliation: Department of Radiation Oncology, University of Lubeck, Germany. Rades.Dirk@gmx.net <Rades.Dirk@gmx.net>
authors.forename: Dirk
authors.initials: D
authors.lastname: Rades
authors.forename: Stefanie
authors.initials: S
authors.lastname: Kronemann
authors.forename: Thekla
authors.initials: T
authors.lastname: Meyners
authors.forename: Steven E
authors.initials: SE
authors.lastname: Schild
authors.forename: Samer G
authors.initials: SG
authors.lastname: Hakim
mesh_terms: D000328:Adult; D000970:Antineoplastic Agents / Q000008:administration & dosage* / Q000627:therapeutic use; D002294:Carcinoma, Squamous Cell / Q000188:drug therapy* / Q000473:pathology / Q000532:radiotherapy*; D002945:Cisplatin / Q000008:administration & dosage* / Q000627:therapeutic use; D003131:Combined Modality Therapy / Q000379:methods; D019583:Dose Fractionation, Radiation; D005260:Female; D006258:Head and Neck Neoplasms / Q000188:drug therapy* / Q000473:pathology / Q000532:radiotherapy*; D006801:Humans; D008297:Male; D016555:Matched-Pair Analysis; D008875:Middle Aged; D009367:Neoplasm Staging; D011446:Prospective Studies
chemical_list: D000970:Antineoplastic Agents; D002945:Cisplatin