title: Concurrent Chemoradiation with Low-Dose Weekly Cisplatin in Locally Advanced Stage IV Head and Neck Squamous Cell Carcinoma.
abstract: OBJECTIVE
  Concurrent chemoradiation (CRT) with 3-weekly doses of cisplatin is a standard treatment for loco-regionally advanced head and neck squamous cell carcinoma (HNSCC). However, treatment with 3-weekly doses of cisplatin is often associated with several adverse events. Therefore, we conducted this retrospective analysis to determine the efficacy and tolerance of CRT with a low weekly dose of cisplatin in stage IV HNSCC patients.
  
  
  METHODS
  Medical records of patients who were diagnosed with stage IV HNSCC and received concurrent CRT were analyzed. All patients were treated weekly with cisplatin at 20-30 mg/m(2) until radiotherapy was completed.
  
  
  RESULTS
  A total of 35 patients were reviewed. Median follow up was 10.7 months (range, 1.7 to 90.5 months), the median radiation dose was 7,040 cGy, and the median dose of cisplatin received was 157 mg/m(2). Eleven patients received docetaxel combination chemotherapy. Overall, 25 patients (71.4%) achieved complete response (CR), eight (22.9%) showed partial response. The median overall survival was 42.7 months, the 3-year survival rate was 51.2% and the 3 year disease-free survival rate was 72.8%. Overall survival was improved in patients who achieved CR relative to others (59.7 months vs. 13.4 months; p=0.008). There were significant differences in survival between patients who received docetaxel combination and cisplatin alone (51.8 months vs. 7.9 months; p=0.009). Grade 3-4 adverse events included stomatitis (82.9%), dermatitis (22.9%), infection (11.4%), dysphagia (8.6%), and neutropenia (5.7%).
  
  
  CONCLUSIONS
  CRT with low dose weekly cisplatin is likely effective and tolerable, even in patients with locally advanced-stage IV HNSCC.
authors: Departments of Internal Medicine, Institute of Health Science, Gyeongsang National University School of Medicine, Jinju, Korea.
authors: Myoung Hee
authors: MH
authors: Kang
authors: Departments of Internal Medicine, Institute of Health Science, Gyeongsang National University School of Medicine, Jinju, Korea.
authors: Jung Hun
authors: JH
authors: Kang
authors: Departments of Internal Medicine, Institute of Health Science, Gyeongsang National University School of Medicine, Jinju, Korea.
authors: Haa-Na
authors: HN
authors: Song
authors: Departments of Radiation Oncology, Institute of Health Science, Gyeongsang National University School of Medicine, Jinju, Korea.
authors: Bae Kwon
authors: BK
authors: Jeong
authors: Departments of Radiation Oncology, Institute of Health Science, Gyeongsang National University School of Medicine, Jinju, Korea.
authors: Gyu Young
authors: GY
authors: Chai
authors: Departments of Radiation Oncology, Institute of Health Science, Gyeongsang National University School of Medicine, Jinju, Korea.
authors: Kimun
authors: K
authors: Kang
authors: Departments of Otorhinolaryngology, Institute of Health Science, Gyeongsang National University School of Medicine, Jinju, Korea.
authors: Seung Hoon
authors: SH
authors: Woo
authors: Departments of Otorhinolaryngology, Institute of Health Science, Gyeongsang National University School of Medicine, Jinju, Korea.
authors: Jung Je
authors: JJ
authors: Park
authors: Departments of Otorhinolaryngology, Institute of Health Science, Gyeongsang National University School of Medicine, Jinju, Korea.
authors: Jin Pyeong
authors: JP
authors: Kim
keywords: Chemoradiotherapy; Cisplatin; Head and neck neoplasms