Definitive chemoradiotherapy with either high-dose or weekly cisplatin in patients with locally advanced squamous cell head and neck cancer: A retrospective analysis.
(2015) ESMO European Cancer Congress — Location: Vienna
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- Background: Radical radiotherapy with concurrent high-dose cisplatin (100mg/m2/3 weeks) chemotherapy remains the standard of care in the non-surgical management of locally advanced head and neck squamous cell carcinoma (HNSCC). However, high-dose cisplatin is an intensive regimen harboring multiple toxicities and many patients are not eligible to receive this regimen due to poor performance status or medical co-morbidities. Weekly cisplatin (40mg/m2) is an alternative regimen during radiotherapy but it is not known whether weekly cisplatin is as effective as high-dose cisplatin. This retrospective analysis compares the toxicities and the early outcome of patients with locally advanced HNSCC treated with exclusive radiotherapy associated with either high-dose cisplatin or weekly cisplatin. Material and methods: We performed a retrospective review of patients with locally advanced HNSCC who received radical radiotherapy associated with either high-dose either weekly cisplatin between december 2010 and december 2013. Patients who did not complete their radiotherapy course and those who received chemoradiotherapy in adjuvant setting were excluded for this analysis. Results: Seventy-three patients were analyzed (43 treated with high-dose cisplatin and 30 with weekly cisplatin). Most patients had carcinoma of the hypo- and oropharynx (75%). Median age was similar in the two regimens (57 years), as well as median performance status (Karnofsky 90). The median number of administered cycle in the high-dose cisplatin and the weekly cisplatin was 2 (range 1-3) and 5 (range 3-7), respectively. The one-year disease free survival for patients who received high-dose and weekly cisplatin was 67.4% and 53.3%, respectively. The one-year overall survival was 81.4% and 70.0%, respectively. Grade 3 hematologic toxicities were observed at same frequency (16%) in the two regimens, as well as grade 3 mucitis (34% in high-dose versus 30% in weekly cisplatin regimen). Conclusion: Although retrospective, our data observed a better early survival with high-dose cisplatin compared to weekly cisplatin in patients with locally advanced HNSCC treated with definitive chemoradiotherapy. Furthermore, toxicities appeared similar between the two groups, suggesting that high-dose cisplatin regimen should be preferred.
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van Marcke de Lummen, C. J., Petit, B., Confente, C., Filleul, B., & Seront, E. (2015). Definitive chemoradiotherapy with either high-dose or weekly cisplatin in patients with locally advanced squamous cell head and neck cancer: A retrospective analysis. European Journal of Cancer, 51(S3), S575. https://doi.org/10.1016/S0959-8049(16)31596-9 (Original work published 2015)