Comparison of weekly administration of cisplatin versus three courses of cisplatin 100 mg-m2 for definitive radiochemotherapy of locally advanced head-and-neck cancersReport as inadecuate




Comparison of weekly administration of cisplatin versus three courses of cisplatin 100 mg-m2 for definitive radiochemotherapy of locally advanced head-and-neck cancers - Download this document for free, or read online. Document in PDF available to download.

BMC Cancer

, 16:437

Medical and radiation oncology

Abstract

BackgroundTo compare definitive radiochemotherapy with weekly administration of 30–40 mg-m of cisplatin to 100 mg-m of cisplatin on days 1, 22 and 43 for outcomes and toxicity in patients with squamous cell carcinoma of the head-and-neck.

MethodsSeventy-five patients receiving radiochemotherapy with weekly cisplatin 30–40 mg-m were compared to 58 patients receiving radiochemotherapy with 100 mg-m cisplatin on days 1, 22 and 43. Radiochemotherapy regimen plus seven characteristics age, gender, performance score, tumor site, T-N-category, histologic grading were evaluated for locoregional control LRC, metastases-free survival MFS and overall survival OS. Radiochemotherapy groups were compared for toxicity.

ResultsOn multivariate analysis, improved LRC was associated with cisplatin 100 mg-m hazard ratio HR 1.57; p = 0.008 and female gender HR 4.37; p = 0.003. Radiochemotherapy regimen was not significantly associated with MFS on univariate analysis p = 0.66. On multivariate analysis, better MFS was associated with ECOG performance score 0–1 HR 5.63; p < 0.001 and histological grade 1–2 HR 1.81; p = 0.002. On multivariate analysis, improved OS was associated with cisplatin 100 mg-m HR 1.33; p = 0.023, ECOG performance score 0–1 HR 2.15; p = 0.029 and female gender HR 1.98; p = 0.026. Cisplatin 100 mg-m was associated with higher rates of grade ≥3 hematotoxicity p = 0.004, grade ≥2 renal failure p = 0.004 and pneumonia-sepsis p = 0.033.

ConclusionsRadiochemotherapy with 100 mg-m of cisplatin every 3 weeks resulted in better LRC and OS than weekly doses of 30–40 mg-m. Given the limitations of a retrospective study, 100 mg-m of cisplatin appears preferable. Since this regimen was associated with considerable acute toxicity, patients require close monitoring.

KeywordsHead-and-neck cancer Definitive treatment Radiochemotherapy Cisplatin Outcomes Adverse events  Download fulltext PDF



Author: Dirk Rades - Daniel Seidl - Stefan Janssen - Amira Bajrovic - Katarina Karner - Primoz Strojan - Steven E Schild

Source: https://link.springer.com/



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