Concurrent Chemoradiation with Low-Dose Weekly Cisplatin in Locally Advanced Stage IV Head and Neck Squamous Cell Carcinoma.
- Author:
Myoung Hee KANG
1
;
Jung Hun KANG
;
Haa Na SONG
;
Bae Kwon JEONG
;
Gyu Young CHAI
;
Kimun KANG
;
Seung Hoon WOO
;
Jung Je PARK
;
Jin Pyeong KIM
Author Information
- Publication Type:Original Article
- Keywords: Head and neck neoplasms; Chemoradiotherapy; Cisplatin
- MeSH: Carcinoma, Squamous Cell*; Chemoradiotherapy; Cisplatin*; Deglutition Disorders; Dermatitis; Disease-Free Survival; Drug Therapy, Combination; Follow-Up Studies; Head and Neck Neoplasms; Head*; Humans; Medical Records; Neck*; Neutropenia; Radiotherapy; Retrospective Studies; Stomatitis; Survival Rate
- From:Cancer Research and Treatment 2015;47(3):441-447
- CountryRepublic of Korea
- Language:English
- Abstract: PURPOSE: Concurrent chemoradiation (CRT) with 3-weekly doses of cisplatin is a standard treatment for loco-regionally advanced head and neck squamous cell carcinoma (HNSCC). However, treatment with 3-weekly doses of cisplatin is often associated with several adverse events. Therefore, we conducted this retrospective analysis to determine the efficacy and tolerance of CRT with a low weekly dose of cisplatin in stage IV HNSCC patients. MATERIALS AND METHODS: Medical records of patients who were diagnosed with stage IV HNSCC and received concurrent CRT were analyzed. All patients were treated weekly with cisplatin at 20-30 mg/m2 until radiotherapy was completed. RESULTS: A total of 35 patients were reviewed. Median follow up was 10.7 months (range, 1.7 to 90.5 months), the median radiation dose was 7,040 cGy, and the median dose of cisplatin received was 157 mg/m2. Eleven patients received docetaxel combination chemotherapy. Overall, 25 patients (71.4%) achieved complete response (CR), eight (22.9%) showed partial response. The median overall survival was 42.7 months, the 3-year survival rate was 51.2% and the 3 year disease-free survival rate was 72.8%. Overall survival was improved in patients who achieved CR relative to others (59.7 months vs. 13.4 months; p=0.008). There were significant differences in survival between patients who received docetaxel combination and cisplatin alone (51.8 months vs. 7.9 months; p=0.009). Grade 3-4 adverse events included stomatitis (82.9%), dermatitis (22.9%), infection (11.4%), dysphagia (8.6%), and neutropenia (5.7%). CONCLUSION: CRT with low dose weekly cisplatin is likely effective and tolerable, even in patients with locally advanced-stage IV HNSCC.
