Cancer Res Treat.  2015 Jul;47(3):441-447. 10.4143/crt.2013.219.

Concurrent Chemoradiation with Low-Dose Weekly Cisplatin in Locally Advanced Stage IV Head and Neck Squamous Cell Carcinoma

• Kang MH
• Kang JH
• Song HN
• Jeong BK
• Chai GY
• Kang K
• Woo SH
• Park JJ
• Kim JP

• KMID: 2148493
• DOI: http://doi.org/10.4143/crt.2013.219

Abstract

PURPOSE
Concurrent chemoradiation (CRT) with 3-weekly doses of cisplatin is a standard treatment for loco-regionally advanced head and neck squamous cell carcinoma (HNSCC). However, treatment with 3-weekly doses of cisplatin is often associated with several adverse events. Therefore, we conducted this retrospective analysis to determine the efficacy and tolerance of CRT with a low weekly dose of cisplatin in stage IV HNSCC patients.
MATERIALS AND METHODS
Medical records of patients who were diagnosed with stage IV HNSCC and received concurrent CRT were analyzed. All patients were treated weekly with cisplatin at 20-30 mg/m2 until radiotherapy was completed.
RESULTS
A total of 35 patients were reviewed. Median follow up was 10.7 months (range, 1.7 to 90.5 months), the median radiation dose was 7,040 cGy, and the median dose of cisplatin received was 157 mg/m2. Eleven patients received docetaxel combination chemotherapy. Overall, 25 patients (71.4%) achieved complete response (CR), eight (22.9%) showed partial response. The median overall survival was 42.7 months, the 3-year survival rate was 51.2% and the 3 year disease-free survival rate was 72.8%. Overall survival was improved in patients who achieved CR relative to others (59.7 months vs. 13.4 months; p=0.008). There were significant differences in survival between patients who received docetaxel combination and cisplatin alone (51.8 months vs. 7.9 months; p=0.009). Grade 3-4 adverse events included stomatitis (82.9%), dermatitis (22.9%), infection (11.4%), dysphagia (8.6%), and neutropenia (5.7%).
CONCLUSION
CRT with low dose weekly cisplatin is likely effective and tolerable, even in patients with locally advanced-stage IV HNSCC.

Keyword

Head and neck neoplasms; Chemoradiotherapy; Cisplatin

MeSH Terms

Carcinoma, Squamous Cell*
Chemoradiotherapy
Cisplatin*
Deglutition Disorders
Dermatitis
Disease-Free Survival
Drug Therapy, Combination
Follow-Up Studies
Head and Neck Neoplasms
Head*
Humans
Medical Records
Neck*
Neutropenia
Radiotherapy
Retrospective Studies
Stomatitis
Survival Rate
Cisplatin

Figure

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  Fig. 1. Overall survival. Median survival is 42.7 months; 3-year survival rate is 51.2%.

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  Fig. 2. Disease-free survival. Disease-free survival does not reach median; 3-year disease-free survival is 72.8%.

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  Fig. 3. Survival curve between patients with confirmed complete response (CR) vs. non-CR (p=0.008).

Reference

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