Late follow-up of the randomized radiation and concomitant high-dose intra-arterial or intravenous cisplatin (RADPLAT) trial for advanced head and neck cancer.
The radiation and concomitant high-dose intra-arterial or intravenous cisplatin (RADPLAT) phase III trial compared intra-arterial (IA) to intravenous (IV) cisplatin-based chemoradiation for head and neck cancer. Long-term efficacy and toxicity are reported after a median follow-up of 7.5 years.



Patients with inoperable squamous cell carcinoma (SCC) of the oropharynx, oral cavity, or hypopharynx, were randomized between radiotherapy (RT) + IA cisplatin 150 mg/m(2) , followed by systemic rescue or RT + I.V. cisplatin 100 mg/m(2) . RT consisted of 46 Gy to the affected and elective areas, followed by a boost of 24 Gy.



Among 237 patients, 57 recurred locally, 35 regionally, and 80 locoregionally. There were 32 second primary tumors, 65 distant metastases, and 154 deaths. Locoregional control and overall survival were not different between the treatment arms. Late dysphagia was worse in the I.V. arm (log-rank p = .014).



IA cisplatin did not improve tumor control compared to I.V. administered cisplatin, despite the higher dose in IA delivery of the drug. © 2015 Wiley Periodicals, Inc. Head Neck 38: E488-E493, 2016.
Department of Radiation Oncology, Netherlands Cancer Institute, Amsterdam, The Netherlands.
Jolien
J
Heukelom
Department of Statics, Netherlands Cancer Institute, Amsterdam, The Netherlands.
Marta
M
Lopez-Yurda
Department of Head and Neck Oncology and Surgery, Netherlands Cancer Institute, Amsterdam, The Netherlands.
Alfons J M
AJ
Balm
Department of Radiation Oncology, Radiotherapeutisch Instituut Friesland, Leeuwarden, The Netherlands.
Oda B
OB
Wijers
Department of Medical Oncology, VU University Medical Center, Amsterdam, The Netherlands.
Jan
J
Buter
Department of Radiation Oncology, Waikato Hospital, Hamilton, New Zealand.
Theo
T
Gregor
Department of Radiation Oncology, Medisch Centrum Haaglanden, The Hague, The Netherlands.
Ruud
R
Wiggenraad
Department of Medical Oncology, Netherlands Cancer Institute, Amsterdam, The Netherlands.
Jan Paul
JP
de Boer
Department of Head and Neck Oncology and Surgery, Netherlands Cancer Institute, Amsterdam, The Netherlands.
I Bing
IB
Tan
Department of Radiation Oncology, Netherlands Cancer Institute, Amsterdam, The Netherlands.
Marcel
M
Verheij
Department of Radiation Oncology, Netherlands Cancer Institute, Amsterdam, The Netherlands.
Jan-Jakob
JJ
Sonke
Department of Radiation Oncology, Amsterdam Medical Center, Amsterdam, The Netherlands.
Coen R
CR
Rasch
D061605:Administration, Intravenous; D002294:Carcinoma, Squamous Cell / Q000628:therapy*; D059248:Chemoradiotherapy; D002945:Cisplatin / Q000627:therapeutic use*; D005260:Female; D005500:Follow-Up Studies; D006258:Head and Neck Neoplasms / Q000628:therapy*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009362:Neoplasm Metastasis; D009364:Neoplasm Recurrence, Local; D015996:Survival Rate
D002945:Cisplatin
chemoradiotherapy; head and neck cancer; intra-arterial cisplatin; late results; radiation oncology; toxicity