title: Safety and efficacy of concurrent carboplatin plus radiotherapy for locally advanced head and neck cancer patients ineligible for treatment with cisplatin.
abstract: OBJECTIVE
  Cisplatin-based chemoradiotherapy is the standard treatment for patients with locally advanced squamous cell carcinoma of the head and neck. However, patients with advanced age, renal, cardiac or neurogenic dysfunction seem ineligible for cisplatin treatment. We evaluated the safety and efficacy of concurrent carboplatin plus radiotherapy in patients ineligible for cisplatin usage.
  
  
  METHODS
  We retrospectively analyzed the records of 25 consecutive locally advanced squamous cell carcinoma of the head and neck patients who received concurrent carboplatin plus radiotherapy at Shizuoka Cancer Center between August 2006 and March 2014. Carboplatin was administered tri-weekly or weekly.
  
  
  RESULTS
  Patient characteristics were analyzed. The median age was 75 years (range, 54-82), male:female ratio, 24:1; performance status, 0-1 (23) or 2 (2); primary tumor site, oropharynx (10), hypopharynx (12), larynx (1) or oral cavity (2); Stage III (3), IVa (19) or IVb (3); induction chemotherapy, with (2) or without (23); and a median creatinine clearance of 62 ml/min (range, 37-117). The main reasons for choosing carboplatin were age (40%), renal impairment (36%) and cardiac dysfunction (20%). All patients received a planned irradiation dose of 70 Gy. Median follow-up was 30.9 months. Complete response was observed 70% patients. Median progression-free survival duration was 42.7 months. Median overall survival could not be analyzed. The 2-year progression-free and overall survival rates were 68 and 74%, respectively. The main toxicity Grade 3 or 4 was oral mucositis (56%), thrombocytopenia (34%), neutropenia (28%) and infection (24%).
  
  
  CONCLUSIONS
  Concurrent carboplatin plus radiotherapy is tolerated and may be an option in treating locally advanced squamous cell carcinoma of the head and neck patients ineligible for treatment with cisplatin.
authors.affiliation: Division of Gastrointestinal Oncology, Shizuoka Cancer Center, Shizuoka.
authors.forename: Satoshi
authors.initials: S
authors.lastname: Hamauchi
authors.affiliation: Division of Gastrointestinal Oncology, Shizuoka Cancer Center, Shizuoka t.yokota@scchr.jp.
authors.forename: Tomoya
authors.initials: T
authors.lastname: Yokota
authors.affiliation: Division of Medical Oncology, Shizuoka Cancer Center, Shizuoka.
authors.forename: Yusuke
authors.initials: Y
authors.lastname: Onozawa
authors.affiliation: Division of Radiation Oncology, Shizuoka Cancer Center, Shizuoka.
authors.forename: Hirofumi
authors.initials: H
authors.lastname: Ogawa
authors.affiliation: Division of Radiation Oncology, Shizuoka Cancer Center, Shizuoka.
authors.forename: Tsuyoshi
authors.initials: T
authors.lastname: Onoe
authors.affiliation: Division of Head and Neck Surgery, Shizuoka Cancer Center, Shizuoka, Japan.
authors.forename: Tomoyuki
authors.initials: T
authors.lastname: Kamijo
authors.affiliation: Division of Head and Neck Surgery, Shizuoka Cancer Center, Shizuoka, Japan.
authors.forename: Yoshiyuki
authors.initials: Y
authors.lastname: Iida
authors.affiliation: Division of Radiation Oncology, Shizuoka Cancer Center, Shizuoka.
authors.forename: Tetsuo
authors.initials: T
authors.lastname: Nishimura
authors.affiliation: Division of Head and Neck Surgery, Shizuoka Cancer Center, Shizuoka, Japan.
authors.forename: Tetsuro
authors.initials: T
authors.lastname: Onitsuka
authors.affiliation: Division of Gastrointestinal Oncology, Shizuoka Cancer Center, Shizuoka.
authors.forename: Hirofumi
authors.initials: H
authors.lastname: Yasui
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000970:Antineoplastic Agents / Q000627:therapeutic use*; D016190:Carboplatin / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D002294:Carcinoma, Squamous Cell / Q000188:drug therapy / Q000473:pathology / Q000532:radiotherapy / Q000628:therapy*; D059248:Chemoradiotherapy; D002945:Cisplatin; D000075202:Contraindications; D018572:Disease-Free Survival; D004334:Drug Administration Schedule; D005260:Female; D006258:Head and Neck Neoplasms / Q000188:drug therapy / Q000473:pathology / Q000532:radiotherapy / Q000628:therapy*; D006801:Humans; D053208:Kaplan-Meier Estimate; D008279:Magnetic Resonance Imaging; D008297:Male; D008499:Medical Records; D008875:Middle Aged; D009367:Neoplasm Staging; D009503:Neutropenia / Q000139:chemically induced; D049268:Positron-Emission Tomography; D012189:Retrospective Studies; D013280:Stomatitis / Q000139:chemically induced; D013921:Thrombocytopenia / Q000139:chemically induced; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome
chemical_list: D000970:Antineoplastic Agents; D016190:Carboplatin; D002945:Cisplatin
keywords: carboplatin; carcinoma squamous cell; chemoradiotherapy; cisplatin; head and neck neoplasms