Chemoradiotherapy with weekly cisplatin 40 mg/m(2) in 103 head-and-neck cancer patients: a cumulative dose-effect analysis.

Full Abstract

BACKGROUND AND PURPOSE: In patients with head-and-neck cancer treated with chemoradiotherapy (CRT), a cisplatin-based regimen is often used. Several treatment schedules are accepted with a cumulative cisplatin dose of 200 mg/m(2) (CisCD200) given during radiotherapy. The aim of this analysis was to investigate feasibility and efficacy of a weekly cisplatin 40 mg/m(2) regimen. PATIENTS AND METHODS: During 08/2001 and 12/2006, 103 patients with squamous head-and-neck cancer received concurrent CRT with intended weekly cisplatin 40 mg/m(2) and were analyzed retrospectively. CRT was definitive for a newly diagnosed primary in 62, postoperative in 16, and for recurrence in 25 patients. Most patients had carcinoma of the hypo- and oropharynx (81%). Patients received a median total dose of 70 Gy (range, 42-71.2 Gy). RESULTS: Only 42 patients (41%) received a CisCD200 predominantly due to hematotoxicity. Actuarial 12- and 18-month overall survival (OS) for patients with and without CisCD200 was 83.3% versus 72.1% (p = 0.19) and 66.7% versus 67.2% (p = 0.86), the 12- and 18-month locoregional control (LRC) 66.7% versus 78.7% (p = 0.325) and 59.5% versus 78.7% (p = 0.109), respectively. Multivariate analysis revealed only type of CRT (definitive vs. recurrent) and T-classification as significant variables predicting OS and LRC. CONCLUSION: Feasibility and efficacy of CRT with weekly cisplatin 40 mg/m2 were suboptimal in this analysis. However, the prospects of weekly cisplatin may be its more suitable integration into emerging trimodality concepts combining CRT with molecularly targeted agents.

Author information

Author/s: Steinmann, Diana (D); Cerny, Bettina (B); Karstens, Johann Hinrich (JH); Bremer, Michael (M);

Affiliation: Department of Radiation Oncology, Medical School Hannover, Hannover, Germany. steinmann.diana(-atsign-)mh-hannover.de

Journal and publication information

Publication Type: Journal Article

Journal: Strahlentherapie und Onkologie : Organ der Deutschen Röntgengesellschaft ... [et al] (Strahlenther Onkol), published in Germany. (Language: eng)

Reference: 2009-Oct; vol 185 (issue 10) : pp 682-8

Dates: Created 2009/10/06; Completed 2009/10/13;

PMID: 19806334, status: MEDLINE (last retrieval date: 10/13/2009, IMS Date: )

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