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

doi:10.1016/j.oraloncology.2016.06.004

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

Radiation Oncology

Research output: Contribution to journal › Article › peer-review

8 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 language	English (US)
Pages (from-to)	67-72
Number of pages	6
Journal	Oral Oncology
Volume	59
DOIs	https://doi.org/10.1016/j.oraloncology.2016.06.004
State	Published - Aug 1 2016

Keywords

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

ASJC Scopus subject areas

Oral Surgery
Oncology
Cancer Research

Access to Document

10.1016/j.oraloncology.2016.06.004

Cite this

Rades, D., Seidl, D., Janssen, S., Bajrovic, A., Hakim, S. G., Wollenberg, B., Karner, K., Strojan, P., & Schild, S. E. (2016). 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? Oral Oncology, 59, 67-72. https://doi.org/10.1016/j.oraloncology.2016.06.004

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? / Rades, Dirk; Seidl, Daniel; Janssen, Stefan et al.
In: Oral Oncology, Vol. 59, 01.08.2016, p. 67-72.

Research output: Contribution to journal › Article › peer-review

Rades, D, Seidl, D, Janssen, S, Bajrovic, A, Hakim, SG, Wollenberg, B, Karner, K, Strojan, P & Schild, SE 2016, '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?', Oral Oncology, vol. 59, pp. 67-72. https://doi.org/10.1016/j.oraloncology.2016.06.004

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title = "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?",

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.",

keywords = "Adverse events, Chemoradiation, Higher-dose cisplatin, LASCCHN, Lower-dose fractionated cisplatin, Treatment outcomes",

author = "Dirk Rades and Daniel Seidl and Stefan Janssen and Amira Bajrovic and Hakim, {Samer G.} and Barbara Wollenberg and Katarina Karner and Primoz Strojan and Schild, {Steven E.}",

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doi = "10.1016/j.oraloncology.2016.06.004",

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T1 - Chemoradiation of locally advanced squamous cell carcinoma of the head-and-neck (LASCCHN)

T2 - Is 20 mg/m2 cisplatin on five days every four weeks an alternative to 100 mg/m2 cisplatin every three weeks?

AU - Rades, Dirk

AU - Seidl, Daniel

AU - Janssen, Stefan

AU - Bajrovic, Amira

AU - Hakim, Samer G.

AU - Wollenberg, Barbara

AU - Karner, Katarina

AU - Strojan, Primoz

AU - Schild, Steven E.

PY - 2016/8/1

Y1 - 2016/8/1

N2 - 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.

AB - 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.

KW - Adverse events

KW - Chemoradiation

KW - Higher-dose cisplatin

KW - LASCCHN

KW - Lower-dose fractionated cisplatin

KW - Treatment outcomes

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