Head and neck cancer; chemotherapy; radiotherapy; weekly cisplatin; radio-chemotherapy; squamous cell carcinoma.
Abstract :
[en] Background
Although commonly used for the treatment of locally advanced head and neck squamous cell carcinoma (HNSCC) concomitant radio-chemotherapy (RT-CT) with weekly cisplatin has not been definitely studied. We conducted a single centre retrospective study with the aim to evaluate efficacy and acute toxicity of definitive concomitant RT-CT with 40 mg/m² weekly cisplatin in patients with locally advanced HNSCC with a particular emphasis on radiotherapy modality (conventional or accelerated) and dose of cisplatin delivered.
Method
One hundred and twelve consecutive patients were included. They were given cisplatin 40 mg/m²/week concomitantly with conventionally fractionated (CFRT) (N = 33) or accelerated (ART) (N = 79) radiotherapy.
Results
Radiotherapy was delivered according to the treatment plan in 104 patients and full dose was given to 107 patients. A median cumulative cisplatin dose of 240 mg/m² was delivered to patients treated with CFRT and of 200 mg/m² to those treated with ART. Overall complete response rate was 81.3%. With a median follow up of 38.4 months, median overall survival was 75 months, not influenced by radiotherapy type or cisplatin dose received. The most clinically significant grade 3 or 4 acute toxicities were stomatitis (35.7%), neutropenia (25%), anemia (12.5%) and acute kidney injury (5.4%).
Conclusion
Our study shows that a median cumulative dose of 200 mg/m² cisplatin can be safely delivered using a weekly regimen to patients treated with concomitant radiotherapy (CFRT or ART). Efficacy results and toxicity compare favourably with those described with triweekly cisplatin RT-CT suggesting that a randomized comparison should be undertaken.
Disciplines :
Oncology
Author, co-author :
SAUTOIS, Brieuc ; Centre Hospitalier Universitaire de Liège - CHU > Service d'oncologie médicale
SCHROEDER, Hélène ; Centre Hospitalier Universitaire de Liège - CHU > Centre d'oncologie
MARTIN, Marie ; Centre Hospitalier Universitaire de Liège - CHU > Service d'oncologie médicale
PIRET, Pascal ; Centre Hospitalier Universitaire de Liège - CHU > Service médical de radiothérapie
DEMEZ, Pierre ; Centre Hospitalier Universitaire de Liège - CHU > Service d'ORL, d'audiophonologie et de chir. cervico-faciale
BOUCHAIN, Olivier ; Centre Hospitalier Universitaire de Liège - CHU > Service d'ORL, d'audiophonologie et de chir. cervico-faciale
MUTIJIMA NZARAMBA, Eugène ; Centre Hospitalier Universitaire de Liège - CHU > Service d'anatomie et cytologie pathologiques
MOREAU, Pierre ; Centre Hospitalier Universitaire de Liège - CHU > Service d'ORL, d'audiophonologie et de chir. cervico-faciale
Language :
English
Title :
Weekly cisplatin with radiotherapy for locally advanced head and neck squamous cell carcinoma.
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