title: A comparison of weekly versus 3-weekly cisplatin during adjuvant radiotherapy for high-risk head and neck cancer.
abstract: To compare cumulative cisplatin dose and toxicity between patients who received 3-weekly versus weekly cisplatin during adjuvant radiotherapy for high-risk head and neck squamous cell carcinoma (HNSCC).
  
  
  
  Consecutive HNSCC patients with involved resection margins and/or extra-capsular extension in two tertiary cancer centers with different institutional practices were identified. Cumulative cisplatin dose was calculated and information on toxicity reviewed and compared between patients who received 3-weekly versus weekly cisplatin.
  
  
  
  Of 270 high risk patients, 60 received 3-weekly 100mg/m(2) and 48 received weekly 50mg/m(2) cisplatin during adjuvant radiotherapy (60-66Gy in 30-33 fractions). Fourteen patients received other chemotherapy schedules and 148 received no chemotherapy. Mean cumulative cisplatin dose was 199.4mg/m(2) (standard error (SE) 5.4) in 3-weekly versus 239.8mg/m(2) (SE 11.0, P=0.001) in weekly treated patients. Cumulative cisplatin ⩾200mg/m(2) was given to 67.7% of patients in the 3-weekly cohort and 85.2% (P=0.039) in the weekly cohort. The rate of feeding tube dependency 6months after treatment, osteoradionecrosis, neutropenic fever, and persistent renal function decline were not statistically different.
  
  
  
  About one half of high-risk HNSCC patients are not eligible for cisplatin during postoperative radiotherapy. Patients treated with weekly 50mg/m(2) cisplatin received a higher cumulative dose with comparable toxicity as patients who received 3-weekly 100mg/m(2) cisplatin. Efficacy and applicability to the frequently used weekly 40mg/m(2) schedule remains to be evaluated.
authors.affiliation: Department of Medical Oncology, University of Groningen, University Medical Center Groningen, Hanzeplein 1, 9713 GZ Groningen, The Netherlands. Electronic address: s.oosting@umcg.nl.
authors.forename: Sjoukje F
authors.initials: SF
authors.lastname: Oosting
authors.affiliation: Division of Medical Oncology and Hematology, University of Toronto, Princess Margaret Cancer Center, 610 University Ave, Toronto, ON M5G 2M9, Canada.
authors.forename: Tom W W
authors.initials: TWW
authors.lastname: Chen
authors.affiliation: Department of Radiation Oncology, University of Toronto, Princess Margaret Cancer Center, 610 University Ave, Toronto, ON M5G 2M9, Canada.
authors.forename: Shao H
authors.initials: SH
authors.lastname: Huang
authors.affiliation: Department of Biostatistics University of Toronto, Princess Margaret Cancer Center, 610 University Ave, Toronto, ON M5G 2M9, Canada.
authors.forename: Lisa
authors.initials: L
authors.lastname: Wang
authors.affiliation: Department of Radiation Oncology, University of Toronto, Princess Margaret Cancer Center, 610 University Ave, Toronto, ON M5G 2M9, Canada.
authors.forename: John
authors.initials: J
authors.lastname: Waldron
authors.affiliation: Department of Otolaryngology and Head and Neck Surgery, University of Toronto, Princess Margaret Cancer Center, 610 University Ave, Toronto, ON M5G 2M9, Canada.
authors.forename: Ralph
authors.initials: R
authors.lastname: Gilbert
authors.affiliation: Department of Otolaryngology and Head and Neck Surgery, University of Toronto, Princess Margaret Cancer Center, 610 University Ave, Toronto, ON M5G 2M9, Canada.
authors.forename: David
authors.initials: D
authors.lastname: Goldstein
authors.affiliation: Department of Otolaryngology and Head and Neck Surgery, University of Groningen, University Medical Center Groningen, Hanzeplein 1, 9713 GZ Groningen, The Netherlands.
authors.forename: Gyorgy B
authors.initials: GB
authors.lastname: Halmos
authors.affiliation: Department of Oral and Maxillofacial Surgery, University of Groningen, University Medical Center Groningen, Hanzeplein 1, 9713 GZ Groningen, The Netherlands.
authors.forename: Max J H
authors.initials: MJH
authors.lastname: Witjes
authors.affiliation: Department of Medical Oncology, University of Groningen, University Medical Center Groningen, Hanzeplein 1, 9713 GZ Groningen, The Netherlands.
authors.forename: Jourik A
authors.initials: JA
authors.lastname: Gietema
authors.affiliation: Department of Radiation Oncology, University of Toronto, Princess Margaret Cancer Center, 610 University Ave, Toronto, ON M5G 2M9, Canada.
authors.forename: Brian
authors.initials: B
authors.lastname: O'Sullivan
authors.affiliation: Department of Radiation Oncology, University of Groningen, University Medical Center Groningen, Hanzeplein 1, 9713 GZ Groningen, The Netherlands.
authors.forename: Johannes A
authors.initials: JA
authors.lastname: Langendijk
authors.affiliation: Division of Medical Oncology and Hematology, University of Toronto, Princess Margaret Cancer Center, 610 University Ave, Toronto, ON M5G 2M9, Canada.
authors.forename: Lillian L
authors.initials: LL
authors.lastname: Siu
authors.affiliation: Division of Medical Oncology and Hematology, University of Toronto, Princess Margaret Cancer Center, 610 University Ave, Toronto, ON M5G 2M9, Canada.
authors.forename: Aaron R
authors.initials: AR
authors.lastname: Hansen
mesh_terms: D000328:Adult; D000368:Aged; D000970:Antineoplastic Agents / Q000008:administration & dosage*; D002294:Carcinoma, Squamous Cell / Q000628:therapy*; D002945:Cisplatin / Q000008:administration & dosage*; D005260:Female; D006258:Head and Neck Neoplasms / Q000628:therapy*; D006801:Humans; D008297:Male; D008875:Middle Aged; D018714:Radiotherapy, Adjuvant; D012189:Retrospective Studies; D012307:Risk Factors; D055815:Young Adult
chemical_list: D000970:Antineoplastic Agents; D002945:Cisplatin
keywords: Adjuvant; Cisplatin; Extra-capsular extension; Head and neck squamous cell carcinoma; Involved margins; Postoperative; Radiotherapy