Definitive Chemoradiotherapy for Squamous Head and Neck Cancer: Cisplatin Versus Carboplatin? A Meta-Analysis

Aguiar, Pedro Nazareth; Tadokoro, Hakaru; Silva, Gislaine Fernandes da; Landgraf, Mayndra Mychelle; Barreto, Carmélia Maria Noia; Filardi, Bruno Andraus; Lopes, Gilberto; Oliveira, Pedro F.; Mello, Ramon Andrade De

doi:10.2217/fon-2016-0068

Cited by 9 publications

(6 citation statements)

References 18 publications

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“…Since, survival benefit associated with concurrent chemoradiation is mainly due to improvement in locoregional control; multiagent radiosensitizing regimens may actually do better than single agent cisplatin. This is supported by the reversal in pattern of failure from locoregional recurrences to distant disease as seen in some of the studies that utilized multiagent regimens . MACH‐NC meta‐analysis on the use of chemotherapy also concluded that polychemotherapy either with platin or 5‐FU was not inferior to mono‐platin .…”

Section: Discussionmentioning

confidence: 86%

Comparing high‐dose cisplatin with cisplatin‐based combination chemotherapy in definitive concurrent chemoradiation setting for locally advanced head and neck squamous cell carcinoma (LAHNSCC)

et al. 2019

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Background High‐dose cisplatin (Cis) is a preferred systemic agent for concurrent chemoradiation (CRT) in locally advanced head and neck squamous cell cancer (LAHNSCC) patients. As some patients are unable to tolerate Cis, this study compares the toxicity and efficacy of weekly cisplatin‐paclitaxel (CP) regimen with Cis. Methods Patients with LAHNSCC receiving definitive chemoradiation either with Cis (Cisplatin—100 mg/m2 q3w x 3) or CP (Cisplatin—20 mg/m2; Paclitaxel—30 mg/m2qw x7) were included. Results Cis and CP groups were comprised of 114 and 111 subjects, respectively. Complete response for Cis versus CP groups was 88% versus 88%, respectively. Median follow‐up for the study was 58.5 months. After adjusting for potential treatment selection bias, no significant differences were evident between Cis and CP groups for overall survival (hazard ratios [HR] 0.85, 95% CI 0.59‐1.21, P = 0.36), progression free survival (HR 0.88, 95% CI 0.62‐1.24, P = 0.46), locoregional control (HR 0.77, 95% CI 0.52‐1.15, P = 0.21), and distant control (HR 0.87, 95% CI 0.61‐1.23, P = 0.42). Patients in the CP group had less acute and chronic toxicities. Conclusions Weekly CP regimen can serve as an alternative systemic therapy with radiation in patients with LAHNSCC who are not fit for Cis.

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Section: Discussionmentioning

confidence: 86%

Comparing high‐dose cisplatin with cisplatin‐based combination chemotherapy in definitive concurrent chemoradiation setting for locally advanced head and neck squamous cell carcinoma (LAHNSCC)

et al. 2019

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“…Carboplatin is anecdotally noted to be less toxic to the inner ear and kidney than cisplatin, but the efficacy of this drug in comparison to cisplatin is unknown. A recent meta-analysis of studies using cisplatin or carboplatin found no statistically significant difference in response rate between the two drugs, though the study may have been underpowered (Aguiar et al, 2016).…”

Section: Existing Studies On Cisplatin Ototoxicity In Head and Neck Cmentioning

confidence: 99%

Chemoradiation-induced hearing loss remains a major concern for head and neck cancer patients

Schmitt

Page

2017

International Journal of Audiology

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“…Several studies have compared carboplatin alone and cisplatin alone for the chemoradiation of head-and-neck cancer [ 30 , 31 , 32 , 33 , 34 , 35 , 36 , 37 , 38 , 39 , 40 , 41 ]. Some of these studies were additionally included in one or two meta-analyses from 2016 [ 46 , 47 ]. However, the results of the studies and meta-analyses were conflicting.…”

Section: Discussionmentioning

confidence: 99%

Chemoradiation with Cisplatin vs. Carboplatin for Squamous Cell Carcinoma of the Head and Neck (SCCHN)

Rades

Zwaan

Soror

et al. 2023

Cancers

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Cisplatin is the standard for the chemoradiation of squamous cell carcinoma of the head and neck (HNSCC). Many patients cannot receive cisplatin due to impaired renal function. This study investigated carboplatin as an alternative option. In total, 131 patients assigned to two courses of cisplatin (20 mg/m2/d1-–5 or 25 mg/m2/d1–4) were matched to 45 patients not suitable for cisplatin and receiving carboplatin (AUC 1.0/d1–5 or AUC 1.5/d1–4). The endpoints included loco-regional control (LRC), metastases-free survival (MFS), overall survival (OS), toxicities, and the completion of chemotherapy. The patients in the carboplatin group were significantly older and had more G3 tumors. Otherwise, the baseline characteristics were balanced. The LRC rates at 2 and 3 years were 77% and 76% in the cisplatin group vs. 69% and 65% in the carboplatin group (p = 0.21). The MFS rates were 83% and 78% vs. 78% and 74% (p = 0.34) and the OS rates 83% and 79% vs. 83% and 75% (p = 0.64), respectively. The outcomes were not significantly different in the subgroups receiving definitive or adjuvant chemoradiation. No significant differences were found regarding toxicities. Non-significantly more patients in the carboplatin group completed their chemotherapy (78% vs. 66%, p = 0.15). Carboplatin was associated with similar outcomes and toxicities as cisplatin, although these patients had worse renal function, more aggressive tumors, and were older. Given the limitations of this study, carboplatin appears an option for patients not suitable for cisplatin.

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Definitive Chemoradiotherapy for Squamous Head and Neck Cancer: Cisplatin Versus Carboplatin? A Meta-Analysis

Abstract: Despite the trend to improved outcomes in using cisplatin, carboplatin is also active and can be a reasonable option to treat patients.

Cited by 9 publications

References 18 publications

Comparing high‐dose cisplatin with cisplatin‐based combination chemotherapy in definitive concurrent chemoradiation setting for locally advanced head and neck squamous cell carcinoma (LAHNSCC)

Comparing high‐dose cisplatin with cisplatin‐based combination chemotherapy in definitive concurrent chemoradiation setting for locally advanced head and neck squamous cell carcinoma (LAHNSCC)

Chemoradiation-induced hearing loss remains a major concern for head and neck cancer patients

Chemoradiation with Cisplatin vs. Carboplatin for Squamous Cell Carcinoma of the Head and Neck (SCCHN)

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