Comparison of weekly administration of cisplatin versus three courses of cisplatin 100 mg/m2 for definitive radiochemotherapy of locally advanced head-and-neck cancers

Dirk Rades, Daniel Seidl, Stefan Janssen, Amira Bajrovic, Katarina Karner, Primoz Strojan, Steven E. Schild

Research output: Contribution to journalArticle

6 Citations (Scopus)

Abstract

Background: To compare definitive radiochemotherapy with weekly administration of 30-40 mg/m2 of cisplatin to 100 mg/m2 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/m2) were compared to 58 patients receiving radiochemotherapy with 100 mg/m2 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/m2 (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/m2 (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/m2 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/m2 of cisplatin every 3 weeks resulted in better LRC and OS than weekly doses of 30-40 mg/m2. Given the limitations of a retrospective study, 100 mg/m2 of cisplatin appears preferable. Since this regimen was associated with considerable acute toxicity, patients require close monitoring.

Original languageEnglish (US)
Article number437
JournalBMC Cancer
Volume16
Issue number1
DOIs
StatePublished - Jul 8 2016

Fingerprint

Chemoradiotherapy
Head and Neck Neoplasms
Cisplatin
Survival
Multivariate Analysis
Neoplasm Metastasis
Renal Insufficiency
Sepsis
Pneumonia
Retrospective Studies

Keywords

  • Adverse events
  • Cisplatin
  • Definitive treatment
  • Head-and-neck cancer
  • Outcomes
  • Radiochemotherapy

ASJC Scopus subject areas

  • Oncology
  • Cancer Research
  • Genetics

Cite this

Comparison of weekly administration of cisplatin versus three courses of cisplatin 100 mg/m2 for definitive radiochemotherapy of locally advanced head-and-neck cancers. / Rades, Dirk; Seidl, Daniel; Janssen, Stefan; Bajrovic, Amira; Karner, Katarina; Strojan, Primoz; Schild, Steven E.

In: BMC Cancer, Vol. 16, No. 1, 437, 08.07.2016.

Research output: Contribution to journalArticle

Rades, Dirk ; Seidl, Daniel ; Janssen, Stefan ; Bajrovic, Amira ; Karner, Katarina ; Strojan, Primoz ; Schild, Steven E. / Comparison of weekly administration of cisplatin versus three courses of cisplatin 100 mg/m2 for definitive radiochemotherapy of locally advanced head-and-neck cancers. In: BMC Cancer. 2016 ; Vol. 16, No. 1.
@article{f0dbaff3dca8484c8a9b2cd78d91865e,
title = "Comparison of weekly administration of cisplatin versus three courses of cisplatin 100 mg/m2 for definitive radiochemotherapy of locally advanced head-and-neck cancers",
abstract = "Background: To compare definitive radiochemotherapy with weekly administration of 30-40 mg/m2 of cisplatin to 100 mg/m2 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/m2) were compared to 58 patients receiving radiochemotherapy with 100 mg/m2 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/m2 (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/m2 (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/m2 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/m2 of cisplatin every 3 weeks resulted in better LRC and OS than weekly doses of 30-40 mg/m2. Given the limitations of a retrospective study, 100 mg/m2 of cisplatin appears preferable. Since this regimen was associated with considerable acute toxicity, patients require close monitoring.",
keywords = "Adverse events, Cisplatin, Definitive treatment, Head-and-neck cancer, Outcomes, Radiochemotherapy",
author = "Dirk Rades and Daniel Seidl and Stefan Janssen and Amira Bajrovic and Katarina Karner and Primoz Strojan and Schild, {Steven E.}",
year = "2016",
month = "7",
day = "8",
doi = "10.1186/s12885-016-2478-8",
language = "English (US)",
volume = "16",
journal = "BMC Cancer",
issn = "1471-2407",
publisher = "BioMed Central",
number = "1",

}

TY - JOUR

T1 - Comparison of weekly administration of cisplatin versus three courses of cisplatin 100 mg/m2 for definitive radiochemotherapy of locally advanced head-and-neck cancers

AU - Rades, Dirk

AU - Seidl, Daniel

AU - Janssen, Stefan

AU - Bajrovic, Amira

AU - Karner, Katarina

AU - Strojan, Primoz

AU - Schild, Steven E.

PY - 2016/7/8

Y1 - 2016/7/8

N2 - Background: To compare definitive radiochemotherapy with weekly administration of 30-40 mg/m2 of cisplatin to 100 mg/m2 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/m2) were compared to 58 patients receiving radiochemotherapy with 100 mg/m2 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/m2 (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/m2 (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/m2 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/m2 of cisplatin every 3 weeks resulted in better LRC and OS than weekly doses of 30-40 mg/m2. Given the limitations of a retrospective study, 100 mg/m2 of cisplatin appears preferable. Since this regimen was associated with considerable acute toxicity, patients require close monitoring.

AB - Background: To compare definitive radiochemotherapy with weekly administration of 30-40 mg/m2 of cisplatin to 100 mg/m2 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/m2) were compared to 58 patients receiving radiochemotherapy with 100 mg/m2 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/m2 (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/m2 (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/m2 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/m2 of cisplatin every 3 weeks resulted in better LRC and OS than weekly doses of 30-40 mg/m2. Given the limitations of a retrospective study, 100 mg/m2 of cisplatin appears preferable. Since this regimen was associated with considerable acute toxicity, patients require close monitoring.

KW - Adverse events

KW - Cisplatin

KW - Definitive treatment

KW - Head-and-neck cancer

KW - Outcomes

KW - Radiochemotherapy

UR - http://www.scopus.com/inward/record.url?scp=84977495694&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84977495694&partnerID=8YFLogxK

U2 - 10.1186/s12885-016-2478-8

DO - 10.1186/s12885-016-2478-8

M3 - Article

C2 - 27391309

AN - SCOPUS:84977495694

VL - 16

JO - BMC Cancer

JF - BMC Cancer

SN - 1471-2407

IS - 1

M1 - 437

ER -