A comparison of weekly versus 3-weekly cisplatin during adjuvant radiotherapy for high-risk head and neck cancer

Sjoukje F. Oosting*, Tom W. W. Chen, Shao H. Huang, Lisa Wang, John Waldron, Ralph Gilbert, David Goldstein, Gyorgy B. Halmos, Max J. H. Witjes, Jourik A. Gietema, Brian O'Sullivan, Johannes A. Langendijk, Lillian L. Siu, Aaron R. Hansen

*Bijbehorende auteur voor dit werk

OnderzoeksoutputAcademicpeer review

11 Citaten (Scopus)
326 Downloads (Pure)

Samenvatting

Objectives: 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).

Materials and methods: Consecutive HNSCC patients with involved resection margins and/or extracapsular 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.

Results: Of 270 high risk patients, 60 received 3-weekly 100 mg/m(2) and 48 received weekly 50 mg/m(2) cisplatin during adjuvant radiotherapy (60-66 Gy in 30-33 fractions). Fourteen patients received other chemotherapy schedules and 148 received no chemotherapy. Mean cumulative cisplatin dose was 199.4 mg/m(2) (standard error (SE) 5.4) in 3-weekly versus 239.8 mg/m(2) (SE 11.0, P = 0.001) in weekly treated patients. Cumulative cisplatin >= 200 mg/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 6 months after treatment, osteoradionecrosis, neutropenic fever, and persistent renal function decline were not statistically different.

Conclusions: About one half of high-risk HNSCC patients are not eligible for cisplatin during postoperative radiotherapy. Patients treated with weekly 50 mg/m(2) cisplatin received a higher cumulative dose with comparable toxicity as patients who received 3-weekly 100 mg/m(2) cisplatin. Efficacy and applicability to the frequently used weekly 40 mg/m(2) schedule remains to be evaluated. (C) 2016 Elsevier Ltd. All rights reserved.

Originele taal-2English
Pagina's (van-tot)43-49
Aantal pagina's7
TijdschriftOral Oncology
Volume59
DOI's
StatusPublished - aug-2016

Citeer dit