title: Relationship between hematotoxicity and serum albumin level in the treatment of head and neck cancers with concurrent chemoradiotherapy using cisplatin.
abstract: OBJECTIVE
  Patients with locally advanced head and neck cancer were treated with concurrent chemoradiotherapy using three courses of cisplatin. However, many patients were unable to complete the scheduled cisplatin treatment due to adverse effects. The objective of this study was to retrospectively elucidate the source of the low completion rate of cisplatin courses.
  
  
  METHODS
  Between November 2007 and 28 May 2010, patients with head and neck cancer were treated with curative intent according to the concurrent chemoradiotherapy protocol (66-70 Gy at 2 Gy/day with cisplatin 80 mg/m(2) on Days 1, 22 and 43). Treatment courses, hematological data and other parameters were investigated, and the treatment completion rates and reasons for treatment failure were analyzed.
  
  
  RESULTS
  Among the 28 patients, cisplatin was administered during the period of radiotherapy a total of 3 times in 9 (32%) patients, 2 times in 15 (54%) patients and only 1 time in 4 (14%) patients. Multiple regression analysis of the development of neutropenia at 3 weeks after the first cisplatin administration revealed that the serum albumin level was a significant explanatory variable (R(2)= 0.664, β = 0.517, P< 0.01). Pearson's product-moment correlation coefficient showed a strong correlation between the serum albumin level and the neutrophil count after 3 weeks (r = 0.605, P< 0.01).
  
  
  CONCLUSIONS
  The treatment completion rate by this protocol was low in head and neck cancer patients even when the cisplatin dose was reduced to 80 mg/m(2). This tendency was seen in patients with a low serum albumin level.
authors.affiliation: Department of Pharmacy, Nagoya University Graduate School of Medicine, 65 Tsuruma-cho, Showa, Nagoya, Aichi 466-8560, Japan. masako-i@med.nagoya-u.ac.jp
authors.forename: Masako
authors.initials: M
authors.lastname: Ishizuka
authors.forename: Yasushi
authors.initials: Y
authors.lastname: Fujimoto
authors.forename: Yoshiyuki
authors.initials: Y
authors.lastname: Itoh
authors.forename: Koichi
authors.initials: K
authors.lastname: Kitagawa
authors.forename: Motoki
authors.initials: M
authors.lastname: Sano
authors.forename: Yasuhiro
authors.initials: Y
authors.lastname: Miyagawa
authors.forename: Atsushi
authors.initials: A
authors.lastname: Ando
authors.forename: Mariko
authors.initials: M
authors.lastname: Hiramatsu
authors.forename: Naoki
authors.initials: N
authors.lastname: Hirasawa
authors.forename: Shunichi
authors.initials: S
authors.lastname: Ishihara
authors.forename: Tsutomu
authors.initials: T
authors.lastname: Nakashima
authors.forename: Kiyofumi
authors.initials: K
authors.lastname: Yamada
mesh_terms: D000328:Adult; D000368:Aged; D000740:Anemia / Q000139:chemically induced; D000970:Antineoplastic Agents / Q000009:adverse effects* / Q000627:therapeutic use; D015992:Body Mass Index; D002294:Carcinoma, Squamous Cell / Q000188:drug therapy* / Q000378:metabolism / Q000473:pathology / Q000532:radiotherapy; D002945:Cisplatin / Q000009:adverse effects* / Q000627:therapeutic use; D003131:Combined Modality Therapy; D003872:Dermatitis / Q000209:etiology; D005260:Female; D006258:Head and Neck Neoplasms / Q000188:drug therapy* / Q000378:metabolism / Q000473:pathology / Q000532:radiotherapy; D006454:Hemoglobins / Q000378:metabolism; D006801:Humans; D007958:Leukocyte Count; D007970:Leukopenia / Q000139:chemically induced; D008297:Male; D008875:Middle Aged; D052016:Mucositis / Q000209:etiology; D009503:Neutropenia / Q000139:chemically induced*; D011878:Radiotherapy / Q000009:adverse effects; D012044:Regression Analysis; D012189:Retrospective Studies; D012709:Serum Albumin / Q000378:metabolism*
chemical_list: D000970:Antineoplastic Agents; D006454:Hemoglobins; D012709:Serum Albumin; D002945:Cisplatin