Weekly cisplatin with radiotherapy for locally advanced head and neck squamous cell carcinoma.
OBJECTIVE
Although commonly used for the treatment of locally advanced head and neck squamous cell carcinoma (HNSCC) concomitant radio-chemotherapy (RT-CT) with weekly cisplatin has not been definitely studied. We conducted a single centre retrospective study with the aim to evaluate efficacy and acute toxicity of definitive concomitant RT-CT with 40 mg/m2weekly cisplatin in patients with locally advanced HNSCC with a particular emphasis on RT modality (conventional or accelerated) and dose of cisplatin delivered.


METHODS
One hundred and twelve consecutive patients were included. They were given cisplatin 40 mg/m2)week concomitantly with conventionally fractionated (CFRT) (N=33) or accelerated (ART) (N=79) RT.


RESULTS
RT was delivered according to the treatment plan in 104 patients and full dose was given to 107 patients. A median cumulative cisplatin dose of 240 mg/m2was administered to patients treated with CFRT and of 200 mg/m2to those treated with ART. Overall complete response rate was 81.3%. With a median follow up of 38.4 months, median overall survival (OS) was 75 months, not influenced by RT type or cisplatin dose received. The most clinically significant grade 3 or 4 acute toxicities were stomatitis (35.7%), neutropenia (25%), anemia (12.5%) and acute kidney injury (5.4%).


CONCLUSIONS
Our study shows that a median cumulative dose of 200 mg/m2cisplatin can be safely administered using a weekly regimen to patients treated with concomitant RT (CFRT or ART). Efficacy results and toxicity compare favorably with those described with triweekly cisplatin RT-CT, suggesting that a randomized comparison should be undertaken.
Department of Medical Oncology, University Hospital of Liege, Belgium.
Brieuc
B
Sautois
Helene
H
Schroeder
Marie
M
Martin
Pascal
P
Piret
Pierre
P
Demez
Olivier
O
Bouchain
Eugene
E
Mutijima
Pierre
P
Moreau
D000328:Adult; D000368:Aged; D002294:Carcinoma, Squamous Cell / Q000188:drug therapy* / Q000532:radiotherapy*; D002945:Cisplatin / Q000008:administration & dosage*; D003131:Combined Modality Therapy / Q000379:methods; D005260:Female; D006258:Head and Neck Neoplasms / Q000188:drug therapy* / Q000532:radiotherapy*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011879:Radiotherapy Dosage
D002945:Cisplatin