Comparing two lower-dose cisplatin programs for radio-chemotherapy of locally advanced head-and-neck cancers

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

Research output: Contribution to journalArticle

3 Scopus citations

Abstract

Radio-chemotherapy is a common treatment for locally advanced squamous cell head-and-neck cancers (LA-SCCHN). Cisplatin (100 mg/m2) every 3 weeks is very common but associated with considerable toxicity. Therefore, cisplatin programs with lower daily doses were introduced. There is a lack of studies comparing lower-dose programs. In this study, 85 patients receiving radio-chemotherapy with 20 mg/m2 cisplatin on 5 days every 4 weeks (group A) were retrospectively compared to 85 patients receiving radio-chemotherapy with 30–40 mg/m2 cisplatin weekly (group B). Groups were matched for nine factors including age, gender, performance score, tumor site, T-/N-category, surgery, hemoglobin before radio-chemotherapy, and radiation technique. One- and 3-year loco-regional control rates were 83 and 69 % in group A versus 74 and 63 % in group B (p = 0.12). One- and 3-year survival rates were 93 % and 73 % in group A versus 91 and 49 % in group B (p = 0.011). On multivariate analysis, survival was significantly better for group A (HR 1.17; p = 0.002). In groups A and B, 12 and 28 % of patients, respectively, did not receive a cumulative cisplatin dose ≥180 mg/m2 (p = 0.016). Toxicity rates were not significantly different. On subgroup analyses, group A patients had better loco-regional control (p = 0.040) and survival (p = 0.005) than group B patients after definitive radio-chemotherapy. In patients receiving adjuvant radio-chemotherapy, outcomes were not significantly different. Thus, 20 mg/m2 cisplatin on 5 days every 4 weeks resulted in better loco-regional control and survival in patients receiving definitive radio-chemotherapy and may be preferable for these patients. Confirmation of these results in a randomized trial is warranted.

Original languageEnglish (US)
Pages (from-to)1-7
Number of pages7
JournalEuropean Archives of Oto-Rhino-Laryngology
DOIs
StateAccepted/In press - Sep 29 2016

Keywords

  • LA-SCCHN
  • Loco-regional control
  • Lower-dose cisplatin
  • Radio-chemotherapy
  • Survival
  • Toxicity

ASJC Scopus subject areas

  • Otorhinolaryngology

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  • Cite this

    Rades, D., Seidl, D., Janssen, S., Strojan, P., Karner, K., Bajrovic, A., Hakim, S. G., Wollenberg, B., & Schild, S. E. (Accepted/In press). Comparing two lower-dose cisplatin programs for radio-chemotherapy of locally advanced head-and-neck cancers. European Archives of Oto-Rhino-Laryngology, 1-7. https://doi.org/10.1007/s00405-016-4326-5