Weekly cisplatin with radiotherapy for locally advanced head and neck squamous cell carcinoma.

Weekly cisplatin with radiotherapy for locally advanced head and neck squamous cell carcinoma.

J BUON. 2016 Jul-Aug;21(4):979-988

Authors: Sautois B, Schroeder H, Martin M, Piret P, Demez P, Bouchain O, Mutijima E, Moreau P

Abstract
PURPOSE: 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/m(2) weekly 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/m(2))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/m(2) was administered to patients treated with CFRT and of 200 mg/m(2) to 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/m(2) cisplatin 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.

PMID: 27685923 [PubMed - as supplied by publisher]

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