Chemoradiation of locally advanced squamous cell carcinoma of the head-and-neck (LASCCHN): Is 20 mg/m2 cisplatin on five days every four weeks an alternative to 100 mg/m2 cisplatin every three weeks?

Dirk Rades, Daniel Seidl, Stefan Janssen, Amira Bajrovic, Samer G. Hakim, Barbara Wollenberg, Katarina Karner, Primoz Strojan, Steven E. Schild

Research output: Contribution to journalArticle

7 Scopus citations

Abstract

SummaryObjectives To compare chemoradiation with 100 mg/m2 cisplatin every three weeks to 20 mg/m2 on five days every four weeks for locally advanced squamous cell carcinoma of the head-and-neck (LASCCHN). Materials and methods In 230 patients receiving chemoradiation for LASCCHN, 100 mg/m2 cisplatin every three weeks (N = 126) and 20 mg/m2 cisplatin on five days every four weeks (N = 104) were retrospectively compared. Chemoradiation plus eleven characteristics (T-/N-classification, performance score, gender, age, tumor site, grading, surgery, radiation technique, pre-chemoradiation hemoglobin, cumulative cisplatin dose) were analyzed for locoregional control (LRC), metastases-free survival (MFS) and overall survival (OS). Chemoradiation groups were compared for adverse events. Results On univariate analyses, chemoradiation had no impact on LRC (p = 0.53), MFS (p = 0.67) and OS (p = 0.14). On multivariate analysis of LRC, T-classification (p = 0.045) and hemoglobin (p <0.001) were significant. On multivariate analysis of MFS, performance score (p = 0.028) was significant. On multivariate analysis of OS, performance score (p = 0.009) and hemoglobin levels (p = 0.002) achieved significance. Chemoradiation with 100 mg/m2 cisplatin was associated with more pneumonia/sepsis (p = 0.003), grade ≥2 nausea/vomiting (p <0.001), grade ≥2 nephrotoxicity (p = 0.005), grade ≥2 xerostomia (p = 0.002), grade ≥3 hematotoxicity (p = 0.052) and grade ≥2 ototoxicity (p = 0.048). Concluding statement 20 mg/m2 cisplatin on five days every four weeks was associated with fewer adverse events than 100 mg/m2 cisplatin every three weeks. 100 mg/m2 cisplatin was not significantly superior to 20 mg/m2 cisplatin regarding LRC, MFS and OS. Given the limitations of a retrospective study, 20 mg/m2 cisplatin appeared preferable. The results should be confirmed in a randomized trial.

Original languageEnglish (US)
Pages (from-to)67-72
Number of pages6
JournalOral Oncology
Volume59
DOIs
StatePublished - Aug 1 2016

    Fingerprint

Keywords

  • Adverse events
  • Chemoradiation
  • Higher-dose cisplatin
  • LASCCHN
  • Lower-dose fractionated cisplatin
  • Treatment outcomes

ASJC Scopus subject areas

  • Oncology
  • Oral Surgery
  • Cancer Research

Cite this