Author/Editor | Rades, Dirk; Seidl, Daniel; Janssen, Stefan; Bajrovic, Amira; Karner, Katarina Barbara; Strojan, Primož; Schild, Steven E. | |
Title | Comparison of weekly administration of cisplatin versus three courses of cisplatin 100 mg/m(2) for definitive radiochemotherapy of locally advanced head-and-neck cancers | |
Type | članek | |
Vol. and No. | , št. Vol. 16 | |
Publication year | 2016 | |
ISSN | 1471-2407 - BMC cancer | |
Language | eng | |
Abstract | To compare definitive radiochemotherapy with weekly administration of 30-40 mg/m(2) of cisplatin to 100 mg/m(2) of cisplatin on days 1, 22 and 43 for outcomes and toxicity in patients with squamous cell carcinoma of the head-and-neck. METHODS: Seventy-five patients receiving radiochemotherapy with weekly cisplatin (30-40 mg/m(2)) were compared to 58 patients receiving radiochemotherapy with 100 mg/m(2) 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. RESULTS: On multivariate analysis, improved LRC was associated with cisplatin 100 mg/m(2) (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(2) (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(2) 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). CONCLUSIONS: Radiochemotherapy with 100 mg/m(2) of cisplatin every 3 weeks resulted in better LRC and OS than weekly doses of 30-40 mg/m(2). Given the limitations of a retrospective study, 100 mg/m(2) of cisplatin appears preferable. Since this regimen was associated with considerable acute toxicity, patients require close monitoring. | |
Keywords | rak glave in vratu zdravljenje radiokemoterapija cisplatin posledice head and neck cancer definitive treatment radiochemotherapy cisplatin outcomes |