Toxicity of daily low dose cisplatin in radiochemotherapy for locally advanced head and neck cancer

J Cancer Res Clin Oncol. 2009 Jul;135(7):961-7. doi: 10.1007/s00432-008-0532-x. Epub 2008 Dec 24.

Abstract

Purpose: To evaluate toxicity of radiochemotherapy schedule using daily-low-dose-cisplatin in radiochemotherapy of locally-advanced head-and-neck-cancer (HNSCC).

Methods and patients: From October 2003 to October 2006, 50 patients with HNSCC (stage III/IVA/IVB) were treated. In 32 patients, surgery and adjuvant radiotherapy(64 Gy), in 18 patients definitive radiotherapy(70 Gy) was performed. Low-dose-cisplatin was applied concomitantly (6 mg/m2/every radiotherapy-day).

Results: Acute toxicity > or =grade 3 was observed in 22 patients (11 patients mucositis/dysphagia, 7 hematologic toxicity, 4 mucositis/dysphagia/hematologic toxicity). 90% of our patients received >80% of the planned cumulative chemotherapy dose, 94% the intended dose of radiotherapy. After median follow-up of 24.2 months, 3-year overall survival and loco-regional control rates were 67.1 and 78%. During follow-up, chronic toxicity > or =grade 3 (xerostomia, subcutaneous fibrosis, or lymphedema) was observed in nine patients.

Conclusion: We found chemoradiation with daily-low-dose-cisplatin to be feasible with advantage of low acute and chronic toxicity. Therefore, use of low-dose-cisplatin should be evaluated in future clinical trials.

Publication types

  • Clinical Trial

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Carcinoma, Squamous Cell / mortality
  • Carcinoma, Squamous Cell / pathology
  • Carcinoma, Squamous Cell / radiotherapy*
  • Carcinoma, Squamous Cell / surgery
  • Cisplatin / administration & dosage*
  • Cisplatin / adverse effects*
  • Disease Progression
  • Dose-Response Relationship, Drug
  • Drug Administration Schedule
  • Drug-Related Side Effects and Adverse Reactions
  • Female
  • Follow-Up Studies
  • Head and Neck Neoplasms / mortality
  • Head and Neck Neoplasms / pathology
  • Head and Neck Neoplasms / radiotherapy*
  • Head and Neck Neoplasms / surgery
  • Humans
  • Male
  • Middle Aged
  • Monitoring, Physiologic
  • Radiation-Sensitizing Agents / administration & dosage
  • Radiation-Sensitizing Agents / adverse effects
  • Radiotherapy, Adjuvant
  • Survival Analysis

Substances

  • Radiation-Sensitizing Agents
  • Cisplatin