title: Predictive factors of head and neck squamous cell carcinoma patient tolerance to high-dose cisplatin in concurrent chemoradiotherapy.
abstract: Although high-dose cisplatin is the standard regimen of concurrent chemoradiotherapy (CCRT) for locally advanced head and neck squamous cell carcinoma (HNSCC), varying levels of patient tolerance towards cisplatin have been reported, and the predictive factors of cisplatin tolerance remain to be elucidated. The present study retrospectively reviewed newly diagnosed HNSCC patients who received CCRT. Cisplatin (80 mg/m2) was administered every 3 weeks. The proportion of high-dose cisplatin-tolerant patients (cumulative cisplatin dose, ≥200 mg/m2) was determined, and the predictive factors of cisplatin tolerance were analyzed in a logistic regression analysis. Between June 2006 and March 2013, a total of 159 patients were treated with CCRT. The median follow-up time was 36.7 months. A total of 73 patients (46%) tolerated a cumulative cisplatin dose ≥200 mg/m2; male gender [odds ratio (OR), 25.00; P=0.005] and high body surface area (BSA) (>1.80 m2; OR, 2.21; P=0.032) were significantly predictive of high-dose cisplatin tolerance. The high-dose cisplatin-tolerant patients had a significantly higher complete response (CR) rate (82 vs. 67%, P=0.045); however, there were no significant between-group differences in the 3-year OS (79.5 vs. 81.2%, P=0.59) or PFS (70.4 vs. 44.6%, P=0.076) by cisplatin tolerance. In clinical practice, approximately one-half of the patients tolerated high-dose cisplatin in CCRT. Male gender and high BSA could be predictive of cisplatin tolerance.
authors.affiliation: Department of Medical Oncology, Cancer Institute Hospital of the Japanese Foundation for Cancer Research, Tokyo 135-8550, Japan.
authors.forename: Kenji
authors.initials: K
authors.lastname: Nakano
authors.affiliation: Department of Medical Oncology, Cancer Institute Hospital of the Japanese Foundation for Cancer Research, Tokyo 135-8550, Japan.
authors.forename: Yasuyoshi
authors.initials: Y
authors.lastname: Sato
authors.affiliation: Department of Radiation Oncology, Cancer Institute Hospital of the Japanese Foundation for Cancer Research, Tokyo 135-8550, Japan.
authors.forename: Takashi
authors.initials: T
authors.lastname: Toshiyasu
authors.affiliation: Department of Pathology, Cancer Institute Hospital of the Japanese Foundation for Cancer Research, Tokyo 135-8550, Japan.
authors.forename: Yukiko
authors.initials: Y
authors.lastname: Sato
authors.affiliation: Department of Medical Oncology, Cancer Institute Hospital of the Japanese Foundation for Cancer Research, Tokyo 135-8550, Japan.
authors.forename: Lina
authors.initials: L
authors.lastname: Inagaki
authors.affiliation: Department of Medical Oncology, Cancer Institute Hospital of the Japanese Foundation for Cancer Research, Tokyo 135-8550, Japan.
authors.forename: Junichi
authors.initials: J
authors.lastname: Tomomatsu
authors.affiliation: Department of Head and Neck Surgery, Cancer Institute Hospital of the Japanese Foundation for Cancer Research, Tokyo 135-8550, Japan.
authors.forename: Toru
authors.initials: T
authors.lastname: Sasaki
authors.affiliation: Department of Head and Neck Surgery, Cancer Institute Hospital of the Japanese Foundation for Cancer Research, Tokyo 135-8550, Japan.
authors.forename: Wataru
authors.initials: W
authors.lastname: Shimbashi
authors.affiliation: Department of Head and Neck Surgery, Cancer Institute Hospital of the Japanese Foundation for Cancer Research, Tokyo 135-8550, Japan.
authors.forename: Hirofumi
authors.initials: H
authors.lastname: Fukushima
authors.affiliation: Department of Head and Neck Surgery, Cancer Institute Hospital of the Japanese Foundation for Cancer Research, Tokyo 135-8550, Japan.
authors.forename: Hiroyuki
authors.initials: H
authors.lastname: Yonekawa
authors.affiliation: Department of Head and Neck Surgery, Cancer Institute Hospital of the Japanese Foundation for Cancer Research, Tokyo 135-8550, Japan.
authors.forename: Hiroki
authors.initials: H
authors.lastname: Mitani
authors.affiliation: Department of Head and Neck Surgery, Cancer Institute Hospital of the Japanese Foundation for Cancer Research, Tokyo 135-8550, Japan.
authors.forename: Kazuyoshi
authors.initials: K
authors.lastname: Kawabata
authors.affiliation: Department of Medical Oncology, Cancer Institute Hospital of the Japanese Foundation for Cancer Research, Tokyo 135-8550, Japan.
authors.forename: Shunji
authors.initials: S
authors.lastname: Takahashi
keywords: aspiration pneumonia; body surface area; cisplatin; concurrent chemoradiotherapy; head and neck squamous cell carcinoma