Quality of life in patients with locally advanced head and neck squamous cell carcinoma undergoing concurrent chemoradiation with once-a-week versus once-every-3-weeks cisplatin

Cancer Med. 2022 Nov;11(21):3939-3948. doi: 10.1002/cam4.4715. Epub 2022 Mar 28.

Abstract

Introduction: This trial was conducted to compare the efficacy of low dose once-a-week cisplatin and once-every-3-weeks cisplatin with radiation in locally advanced head and neck squamous cell carcinoma (LAHNSCC). The current analysis focuses on the quality of life (QoL) of patients in this trial.

Methods: In this phase III randomized trial, patients with nonmetastatic LAHNSCC were randomized to receive cisplatin 30 mg/m2 once-a-week or 100 mg/m2 once every- 3-weeks concurrently with radiotherapy. The primary endpoint was locoregional control. QoL was a key secondary endpoint. QoL was assessed using EORTC QLQ-C30 and QLQ-H&N35. QoL data were assessed at baseline, days 22 and 43 during treatment; and at 6, 12, 24 months. The linear mixed-effects model was used for longitudinal analysis of QoL to determine the impact of treatment (arm) and time on QoL.

Results: Three hundred patients were enrolled, data of 150 patients with available baseline QoL were analyzed. There was no significant difference in the global health status/QoL of the two treatment arms (p = 0.8664). There was no significant difference in the longitudinal QoL scores between the two treatment arms in all scales except constipation (p = 0.0096), less sexuality (p = 0.0002,), and financial difficulty (p = 0.0219). There was a worsening of the QoL scores in all scales in both arms during treatment, which improved after treatment completion in most scales.

Conclusion: The use of once-every-3-weeks cisplatin did not adversely impact QoL as compared to once-a-week cisplatin in combination with radiotherapy in LAHNSCC.

Keywords: chemoradiation; cisplatin; head and neck cancer; quality of life.

Publication types

  • Randomized Controlled Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Antineoplastic Agents* / therapeutic use
  • Cisplatin / adverse effects
  • Head and Neck Neoplasms* / drug therapy
  • Humans
  • Quality of Life
  • Squamous Cell Carcinoma of Head and Neck / drug therapy

Substances

  • Cisplatin
  • Antineoplastic Agents

Associated data

  • CTRI/CTRI/2012/10/ 003062