title: Concomitant weekly cisplatin and radiotherapy for head and neck cancer.
abstract: OBJECTIVE
  The most common chemoradiotherapy regimen is high-dose (100 mg/m(2)) three-weekly cisplatin with concomitant radiotherapy; however, this protocol is associated with acute and late toxicities. Here, we reviewed the dose intensity and toxicity for concomitant weekly cisplatin and radiotherapy in patients with head and neck cancer.
  
  
  METHODS
  Fifty-three patients with untreated head and neck cancer were enrolled and evaluated at our institution from April 2006 to April 2010. Weekly cisplatin (40 mg/m(2)) was given on weeks 1, 2, 3, 5, 6 and 7 with radiotherapy, which comprised a standard dose of 70 Gy delivered in 35 daily fractions over 7 weeks.
  
  
  RESULTS
  Fifty-one patients (96.2%) received the full dose of radiotherapy, while the course was disrupted by adverse events in two. Over the course of the chemotherapy, 31 patients (58.5%) received more than 200 mg/m(2) cisplatin. The toxicity was manageable in all except one patient, who died of sepsis after completing treatment. The 2-year overall survival rate and local progression-free rate for all patients were 93.7% and 88.0%, respectively. The primary site showed a complete response in 52 patients (98.1%) and a partial response in 1 patient (1.9%). The primary disease was well controlled by chemoradiotherapy in 47 patients (88.7%).
  
  
  CONCLUSIONS
  Weekly cisplatin could be easier to manage than three-weekly cisplatin, because patients can be monitored more regularly for toxicity allowing the schedule to be altered if required. This regimen appears to be a suitable alternative to three-weekly high-dose cisplatin with concomitant radiotherapy.
authors.affiliation: Department of Otolaryngology-Head & Neck Surgery, Hokkaido University Graduate School of Medicine, Kita 15, Nishi 7, Kita-ku, Sapporo 060-8638, Japan. ak-homma@med.hokudai.ac.jp
authors.forename: Akihiro
authors.initials: A
authors.lastname: Homma
authors.forename: Naoya
authors.initials: N
authors.lastname: Inamura
authors.forename: Nobuhiko
authors.initials: N
authors.lastname: Oridate
authors.forename: Seigo
authors.initials: S
authors.lastname: Suzuki
authors.forename: Hiromitsu
authors.initials: H
authors.lastname: Hatakeyama
authors.forename: Takatsugu
authors.initials: T
authors.lastname: Mizumachi
authors.forename: Satoshi
authors.initials: S
authors.lastname: Kano
authors.forename: Tomohiro
authors.initials: T
authors.lastname: Sakashita
authors.forename: Rikiya
authors.initials: R
authors.lastname: Onimaru
authors.forename: Koichi
authors.initials: K
authors.lastname: Yasuda
authors.forename: Hiroki
authors.initials: H
authors.lastname: Shirato
authors.forename: Satoshi
authors.initials: S
authors.lastname: Fukuda
mesh_terms: D000328:Adult; D000368:Aged; D000970:Antineoplastic Agents / Q000008:administration & dosage* / Q000009:adverse effects; D002277:Carcinoma / Q000188:drug therapy* / Q000473:pathology / Q000532:radiotherapy*; D002945:Cisplatin / Q000008:administration & dosage* / Q000009:adverse effects; D003131:Combined Modality Therapy; D018572:Disease-Free Survival; D019583:Dose Fractionation, Radiation; D005260:Female; D006801:Humans; D007012:Hypopharyngeal Neoplasms / Q000188:drug therapy / Q000473:pathology / Q000532:radiotherapy; D053208:Kaplan-Meier Estimate; D007822:Laryngeal Neoplasms / Q000188:drug therapy / Q000473:pathology / Q000532:radiotherapy; D008297:Male; D008875:Middle Aged; D009959:Oropharyngeal Neoplasms / Q000188:drug therapy / Q000473:pathology / Q000532:radiotherapy; D010039:Otorhinolaryngologic Neoplasms / Q000188:drug therapy* / Q000473:pathology / Q000532:radiotherapy*; D011882:Radiotherapy, High-Energy / Q000009:adverse effects*; D012189:Retrospective Studies; D015996:Survival Rate; D016896:Treatment Outcome
chemical_list: D000970:Antineoplastic Agents; D002945:Cisplatin