title: Equivalence of cisplatin and carboplatin-based chemoradiation for locally advanced squamous cell carcinoma of the head and neck: a matched-pair analysis.
abstract: BACKGROUND
  Carboplatin can be substituted for cisplatin in concomitant chemoradiation (CRT) for locally advanced squamous cell carcinoma of the head and neck (LASCCHN) when the latter is contraindicated. This matched-pair study aimed to compare the efficacy and acute toxicity of carboplatin and cisplatin.
  
  
  METHODS
  Patients treated with 2 cycles of concomitant carboplatin-based CRT were matched to patients treated with 2 cycles of cisplatin. Matching criteria included age, tumour site, stage, smoking status and use of induction chemotherapy. Radiation was delivered using conformal techniques. Data on weekly acute toxicity throughout CRT was compared using the chi-squared test for proportions. Kaplan Meier statistics described time to local relapse, distant relapse and overall survival, the log-rank test was used to compare 3-year survival outcomes.
  
  
  RESULTS
  Sixty-five patients who received carboplatin were matched to 65 who received cisplatin. Significant differences in toxicity included increased emesis with cisplatin and more anaemia and thrombocytopenia with carboplatin. There was no significant difference in 3-year locoregional control (87% vs. 79%, p=0.54), freedom from distant metastases (88% vs. 85%, p=0.79) and overall survival (59% vs. 68%, p=0.24) between the carboplatin and cisplatin cohorts, respectively.
  
  
  CONCLUSIONS
  When cisplatin is contraindicated, carboplatin-based CRT yields equivalent treatment outcomes in patients with LASCCHN.
authors.affiliation: Head and Neck Unit, Royal Marsden Hospital, London and Surrey, United Kingdom.
authors.forename: A C
authors.initials: AC
authors.lastname: Wilkins
authors.forename: N
authors.initials: N
authors.lastname: Rosenfelder
authors.forename: U
authors.initials: U
authors.lastname: Schick
authors.forename: S
authors.initials: S
authors.lastname: Gupta
authors.forename: K
authors.initials: K
authors.lastname: Thway
authors.forename: C M
authors.initials: CM
authors.lastname: Nutting
authors.forename: K J
authors.initials: KJ
authors.lastname: Harrington
authors.forename: K
authors.initials: K
authors.lastname: Newbold
authors.forename: S A
authors.initials: SA
authors.lastname: Bhide
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000009:adverse effects / Q000627:therapeutic use*; D016190:Carboplatin / Q000008:administration & dosage; D002294:Carcinoma, Squamous Cell / Q000188:drug therapy / Q000532:radiotherapy / Q000628:therapy*; D002945:Cisplatin / Q000008:administration & dosage; D015331:Cohort Studies; D003131:Combined Modality Therapy; D005260:Female; D006258:Head and Neck Neoplasms / Q000188:drug therapy / Q000532:radiotherapy / Q000628:therapy*; D006801:Humans; D008297:Male; D016555:Matched-Pair Analysis; D008875:Middle Aged; D016019:Survival Analysis
chemical_list: D016190:Carboplatin; D002945:Cisplatin