Cumulative cisplatin dose in concurrent chemoradiotherapy for head and neck cancer: A systematic review.
The optimal cumulative dose and timing of cisplatin administration in various concurrent chemoradiotherapy protocols for nonmetastatic head and neck squamous cell carcinoma (HNSCC) has not been determined.



The absolute survival benefit at 5 years of concurrent chemoradiotherapy protocols versus radiotherapy alone observed in prospective randomized trials reporting on the use of cisplatin monochemotherapy for nonnasopharyngeal HNSCC was extracted. In the case of nonrandomized studies, the outcome results at 2 years were compared between groups of patients receiving different cumulative cisplatin doses.



Eleven randomized trials and 7 nonrandomized studies were identified. In 6 definitive radiotherapy phase III trials, a statistically significant association (p = .027) between cumulative cisplatin dose, independent of the schedule, and overall survival benefit was observed for higher doses.



Results support the conclusion that the cumulative dose of cisplatin in concurrent chemoradiation protocols for HNSCC has a significant positive correlation with survival. © 2015 Wiley Periodicals, Inc. Head Neck 38: E2151-E2158, 2016.
Department of Radiation Oncology, Institute of Oncology, Ljubljana, Slovenia.
Primož
P
Strojan
Department of Medical Oncology, Antwerp University Hospital, Edegem, Belgium.
Jan B
JB
Vermorken
Departments of Radiation Oncology, Otolaryngology, and Medical Oncology, Emory University School of Medicine, Atlanta, Georgia.
Jonathan J
JJ
Beitler
Department of Hematology and Medical Oncology, The Winship Cancer Institute of Emory University, Atlanta, Georgia.
Nabil F
NF
Saba
Department of Medicine, Division of Oncology, Albert Einstein College of Medicine, Montefiore Medical Center, Bronx, New York.
Missak
M
Haigentz
Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy.
Paolo
P
Bossi
Department of Internal Medicine, University of Michigan Comprehensive Cancer Center, Ann Arbor, Michigan.
Francis P
FP
Worden
Department of Radiation Oncology, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands.
Johannes A
JA
Langendijk
Department of Radiation Oncology, University of Michigan, Ann Arbor, Michigan.
Avraham
A
Eisbruch
Department of Radiation Oncology, University of Florida, Gainesville, Florida.
William M
WM
Mendenhall
Center of Clinical Oncology, University of Hong Kong - Shenzhen Hospital, Shenzhen, China.
Anne W M
AW
Lee
Department of Radiation Oncology, Beth Israel Medical Center and St Luke's-Roosevelt Hospitals, New York, New York.
Louis B
LB
Harrison
Department of Otolaryngology-Head and Neck Surgery, University of Michigan, Ann Arbor, Michigan.
Carol R
CR
Bradford
Department of Radiation Oncology, The Prince of Wales Cancer Centre, Sydney, New South Wales, Australia.
Robert
R
Smee
Departments of Surgery and Otolaryngology-Head and Neck Surgery, Albert Einstein College of Medicine, Montefiore Medical Center, Bronx, New York.
Carl E
CE
Silver
University of Udine School of Medicine, Udine, Italy.
Alessandra
A
Rinaldo
University of Udine School of Medicine, Udine, Italy.
Alfio
A
Ferlito
D000971:Antineoplastic Combined Chemotherapy Protocols; D002294:Carcinoma, Squamous Cell / Q000628:therapy*; D059248:Chemoradiotherapy; D002945:Cisplatin / Q000627:therapeutic use*; D017326:Clinical Trials, Phase III as Topic; D018572:Disease-Free Survival; D004305:Dose-Response Relationship, Drug; D006258:Head and Neck Neoplasms / Q000628:therapy*; D006801:Humans; D065228:Non-Randomized Controlled Trials as Topic; D016032:Randomized Controlled Trials as Topic; D016896:Treatment Outcome
D002945:Cisplatin
cisplatin; concurrent chemoradiotherapy; cumulative dose; outcome; radiotherapy