Dose intensity comparison between weekly and 3-weekly Cisplatin delivered concurrently with radical radiotherapy for head and neck cancer: A retrospective comparison from New Cross Hospital, Wolverhampton, UK

Ho, Kean F; Swindell, Ric; Brammer, Caroline

doi:10.1080/02841860701846160

Cited by 99 publications

(109 citation statements)

References 17 publications

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“…Despite improved survival and LRC compared to radiotherapy alone compliance with CRT regimens is suboptimal in many cases [1]. To limit toxicity, alternative schedules with reduced single doses of cisplatin have been established in HNSCC patients like 20 mg/m 2 d1-5 (week 1 and 5) [2,23], weekly 30 or 40 mg/m 2 [5,17] or even daily 6 mg/m 2 of cisplatin [18,26], but to date published data are comparably rare. Common to all schedules is the aim to achieve a cumulative cisplatin dose of at least 200 mg/m 2 (CisCD200), although the adequacy of this threshold dose remains to be proven.…”

Section: Introductionmentioning

confidence: 99%

Chemoradiotherapy with Weekly Cisplatin 40 mg/m2 in 103 Head-and-Neck Cancer Patients

et al. 2009

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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/m 2 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. Radiochemotherapie mit wöchentlichenCisplatingaben von 40 mg/m 2 bei 103 Patienten mit Kopf-Hals-Tumoren. Kumulative Cisplatindosis und Überleben Hintergrund und Ziel: Bei der Radiochemotherapie (CRT) von Patienten mit Kopf-Hals-Tumoren wird häufig eine platinhaltige Chemotherapie gewählt. Verschiedene Behandlungsschemata zielen auf eine kumulative Dosis von mindestens 200 mg/m 2 Cisplatin (CisCD200) simultan zur Bestrahlung. Ziel dieser Studie war es, die Wirksamkeit und Verträglichkeit wöchentlicher Cisplatingaben von 40 mg/m 2 zu untersuchen. Patienten und Methodik: Im Zeitraum von 08/2001 bis 12/2006 erhielten 103 Patienten mit Kopf-Hals-Tumoren eine CRT mit geplanten wöchentlichen Cisplatingaben von 40 mg/m 2 und wurden retrospektiv ausgewertet. 62 Patienten bekamen eine definitive CRT bei primär diagnostizierten Tumoren, 16 Patienten wurden postoperativ und 25 Patienten in einer Rezidivsituation behandelt. Hypo-oder Oropharynxkarzinome lagen in 81% (Tabelle 1) der Fälle vor. Die mediane Gesamtdosis betrug 70 Gy (Streubreite 42-71,2 Gy, Tabelle 2). Ergebnisse: Nur 42 Patienten (41%) erreichten die CisCD200 (Tabelle 3), hauptsächlich aufgrund erhöhter Hämatotoxizität. Das Gesamtüberleben (OS) nach 12 und 18 Monaten (Abbildung 1) betrug für die Patienten mit und ohne CisCD200 83,3% versus 72,1% (p = 0,19) und 66,7% versus 67,2% (p = 0,86). Die lokoregionäre Kontrolle (LRC) betrug nach 12 und 18 Monaten (Abbildung 2) 66,7% versus 78,7% ...

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Section: Introductionmentioning

confidence: 99%

Chemoradiotherapy with Weekly Cisplatin 40 mg/m2 in 103 Head-and-Neck Cancer Patients

et al. 2009

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“…Espeli et al reported higher incidence of grade II -III skin toxicity for 3-weekly group as compared to weekly group (p=0.5) (Espeli et al, 2012). Similarly, Ho et al found that patients treated with 3-weekly cisplatin seemed to suffer more grade 3 radiation dermatitis (56% vs. 26%), although not statistically significant (Ho et al, 2008).…”

Section: 1617 Three Weekly Versus Weekly Cisplatin As Radiosensitizementioning

confidence: 91%

“…Three-weekly regimen was found to be associated with more delays (41% vs 29%) and omissions of CT (17.4% vs 5.6%) resulting in lesser patients achieving cumulative doses beyond 200 mg/ m2, potentially lowering dose-intensity (Ho et al, 2008). The average dose intensity of weekly cisplatin (26.5mg/ m2/week) has been reported to be equivalent to that of three-weekly regimen (28.9 mg/m 2 /week) (Homma et al, 2011).…”

Section: Treatment Interruptionmentioning

confidence: 99%

Three Weekly Versus Weekly Cisplatin as Radiosensitizer in Head and Neck Cancer: a Decision Dilemma

Negi¹,

Kingsley²,

Srivastava³

et al. 2016

Asian Pacific Journal of Cancer Prevention

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Cisplatin-based concurrent chemoradiation plays an undisputed key role as definitive treatment in unresectable patients with locally advanced squamous cell carcinoma head and neck or as an organ preservation strategy. Treatment with 100 mg/m2 3-weekly cisplatin is considered the standard of care but is often associated with several adverse events. The optimum drug schedule of administration remains to be defined and presently, there is insufficient data limiting conclusions about the relative tolerability of one regimen over the other. This review addresses regarding the optimal dose schedule of cisplatin focusing mainly on three-weekly and weekly dose of cisplatin based concurrent chemoradiotherapy in locally advanced head and neck cancer with an emphasis on mucositis, dermatitis, systemic toxicity, compliance, and treatment interruptions. To derive a definitive conclusion, large prospective randomized trials are needed directly comparing standard 3-weekly cisplatin (100 mg/m 2 ) with weekly schedule (30 -40 mg/m 2 ) of concurrent cisplatin based chemoradiotherapy in locally advanced squamous cell carcinoma head and neck.

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“…[7,19] We reported the efficacy of weekly cis-platinum concurrent with RT; 3 years DFS, OS and LPS were 69%, 77% and 73% respectively. Our clinical results were consistent with other series; in spite of the smaller sample size with a shorter follow-up period.…”

Section: Discussionmentioning

confidence: 99%

“…[15,16] Also, weekly cisplatin has been used successfully in concurrent CRT for bladder preservation. [17,18] In a study from New Cross Hospital, UK; [19] they retrospectively compared the differences in dose intensity, treatment delay and treatment-related toxicity between the weekly and three weekly cisplatin protocols when concurrently administered with RT to treat patients with locally advanced HNC. Cisplatin (100 mg/m 2 ) 3-weekly with concurrent RT was found to be less tolerated than 40 mg/m 2 weekly regimen, with fewer patients achieved cumulative dose beyond 200 mg/m 2 , which decrease chemotherapy dose intensity.…”

Section: Discussionmentioning

confidence: 99%

Retrospective analysis of the clinical efficacy of concurrent weekly cisplatinum – radiotherapy for patients with laryngeal carcinoma

Aboziada

Elyamany

2016

JST

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Introduction and aim: Laryngeal preservation with concurrent chemo-radiation is an effective, alternative management for cancer larynx. Three weekly cis-platinum concurrent with radiotherapy (RT) considered the standard. However, weekly cisplatinum has proven very effective for advanced head and neck carcinoma. We review our data to prove the efficacy and safety of weekly cis-platinum plus RT for laryngeal preservation. Patients and methods: Untreated 64 patients with advanced laryngeal carcinoma were retrospectively analyzed. Patients offered for 6 weeks of cis-platinum 40 mg/m 2 concurrent with conformal RT; 70 Gy delivered to gross primary and lymph nodes.Results: Forty-six (71.8%) patients had complete remission (CR). Early stages had better CR than late stages. Median follow up was 40 months. Three years DFS and OS were 69% and 77% respectively. Larynx preservation survival at 3 years was 73%. Protocol of treatment was tolerable, grade 3 or 4 acute and late toxic effects were reported in 25% of the included cases. Conclusion: Weekly cis-platinum could be effective and safe. We need to evaluate this protocol prospectively and compare it with three-weekly high dose cis-platinum with concomitant radiotherapy.

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Dose intensity comparison between weekly and 3-weekly Cisplatin delivered concurrently with radical radiotherapy for head and neck cancer: A retrospective comparison from New Cross Hospital, Wolverhampton, UK

Cited by 99 publications

References 17 publications

Chemoradiotherapy with Weekly Cisplatin 40 mg/m2 in 103 Head-and-Neck Cancer Patients

Chemoradiotherapy with Weekly Cisplatin 40 mg/m2 in 103 Head-and-Neck Cancer Patients

Three Weekly Versus Weekly Cisplatin as Radiosensitizer in Head and Neck Cancer: a Decision Dilemma

Retrospective analysis of the clinical efficacy of concurrent weekly cisplatinum – radiotherapy for patients with laryngeal carcinoma

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