The comparison of weekly and three-weekly cisplatin chemotherapy concurrent with radiotherapy in patients with previously untreated inoperable non-metastatic squamous cell carcinoma of the head and neck

Uygun, Kazım; Bılıcı, Ahmet; Karagöl, Hakan; Çaloğlu, Murat; Çiçin, İrfan; Aksu, Görkem; Fayda, Merdan; Uzunoğlu, Sernaz

doi:10.1007/s00280-008-0911-7

Cited by 49 publications

(45 citation statements)

References 20 publications

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“…Six studies supplied data of grade≥3 neutropenia [6, 8, 10–13] among which included 178 patients in the weekly group and 194 patients in the three weekly group. Forest plot showed that patients in the two arms had similar risk of neutropenia and thrombocytopenia with RR of o.85 and 1.13, respectively (95%CI 0.49-1.48, p=0.57; 95%CI 0.42-3.01, p=0.81) (Supplementary Figure S1 and S2).…”

Section: Resultsmentioning

confidence: 99%

“…The data of grade≥3 nausea/vomiting were extracted from six eligible studies [6, 10–13, 15] including 219 patients in weekly group and 224 patients in three weekly group. Patients treated with three weekly cisplatin seemed to be more prone to occur nausea and/or vomiting than those with weekly (RR=0.59, 95%CI 0.34-1.02, p=0.06) (Supplementary Figure S4).…”

Section: Resultsmentioning

confidence: 99%

“…Eight articles [6, 8–10, 12–15] of 624 patients reported the data of mucosal toxicity. No obvious difference was observed for the risk of grade≥3 mucositis between the two groups.…”

Section: Resultsmentioning

confidence: 99%

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A meta-analysis of weekly cisplatin versus three weekly cisplatin chemotherapy plus concurrent radiotherapy (CRT) for advanced head and neck cancer (HNC)

Guan

Zhang

et al. 2016

Oncotarget

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PurposeThis study was performed to compare the efficacies and acute toxicities in weekly- and three weekly- cisplatin based concurrent chemoradiotherapy (CCRT) for advanced HNC patients.Results779 patients of 10 studies were eligible. No difference in the 2-, 3-year OS or 1-, 2-year LRFS was observed, whereas patients in three weekly CCRT arm tended to have a better 5-year OS (HR=1.79, 95%C 0.97-3.31, p=0.06). Weekly arm seemed to show less gastrointestinal toxicities (RR=0.59, 95%CI 0.34-1.02, p=0.06), but similar hematologic toxicity compared to three weekly arm. Subgroup analysis displayed more grade ≥3 mucositis (RR=1.72, p=0.01), and more chemotherapy related delay/interrupt (RR=2.68, p<0.0001) in weekly arm for non-nasopharynx carcinoma (non-NPC) HNC.MethodsWe conducted the meta-analysis by searching PubMed, MEDLINE, ScienceDirect, Cochrane Library and China National Knowledge Infrastructure (CNKI) databases. The primary endpoint was overall survival (OS) with secondary endpoints locoregional recurrence-free survival (LRFS) and grade≥3 acute adverse events. RevMan 5.2 was used to perform statistical analyses.ConclusionsThree weekly cisplatin-based CCRT might achieve a higher long-term OS with no significant difference in a shorter OS and LRFS. Weekly arm was associated with less gastrointestinal toxicities but more grade≥3 mucositis and chemotherapy related delay/interrupt. Large randomized trials were urgent to further define superiority of these two regimens.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

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A meta-analysis of weekly cisplatin versus three weekly cisplatin chemotherapy plus concurrent radiotherapy (CRT) for advanced head and neck cancer (HNC)

Guan

Zhang

et al. 2016

Oncotarget

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“…In the present study, 69.8% of patients underwent ≥ 6 cycles of weekly cisplatin at 30 mg/m 2 and 63.1% with 40 mg/m 2 . To our knowledge, no randomized trial has been performed to determine the optimal cisplatin delivery for NPC; the only prospective randomized trial that compared cisplatin dose schedules for HNSCC was reported by Uygun et al [22]. Cisplatin was delivered according to 3 different schedules: daily (6 mg/m 2 ), weekly (40 mg/m 2 ), and every 3 weeks (100 mg/m 2 ); their efficacy was similar.…”

Section: Discussionmentioning

confidence: 99%

Pretreatment Epstein-Barr Virus DNA Load and Cumulative Cisplatin Dose Intensity Affect Long-Term Outcome of Nasopharyngeal Carcinoma Treated with Concurrent Chemotherapy: Experience of an Institute in an Endemic Area

Wei

Huang

et al. 2014

Oncol Res Treat

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Background: We retrospectively compared the long-term efficacy of concurrent chemoradiotherapy (CCRT) regimens (docetaxel vs. cisplatin), total dose intensity of cisplatin (> 200 vs. ≤ 200 mg/m²) and pretreatment plasma levels of Epstein-Barr virus (EBV) DNA for nasopharyngeal carcinoma (NPC), and investigated the prognostic factors. Methods: We enrolled 214 patients diagnosed with NPC and treated with CCRT. 41 patients received weekly docetaxel and 173 weekly cisplatin. 62 received cumulative cisplatin of ≤ 200 mg/m² and 111, > 200 mg/m². Pretreatment levels of EBV DNA were available for 155 patients. Results: Patients receiving concurrent weekly docetaxel and cisplatin had similar 5-year rates for overall survival (OS) (p = 0.306), progression-free survival (PFS) (p = 0.133), distant failure-free survival (DFS) (p = 0.110), and locoregional failure-free survival (LFS) (p = 0.452). Cumulative cisplatin of > 200 mg/m² improved the 5-year rates of PFS (p = 0.018) and DFS (p = 0.042) significantly in comparison with cumulative cisplatin of ≤ 200 mg/m². EBV DNA levels of ≥ 1,500 copies/ml was closely associated with poor DFS (p = 0.011), PFS (p = 0.006), and OS (p = 0.004). Conclusions: Weekly cisplatin was well tolerated in CCRT, during which cumulative cisplatin of > 200 mg/m² improved PFS and DFS. The long-term efficacy of concurrent docetaxel was similar to that of concurrent cisplatin. The EBV DNA level was the most significant prognostic factor.

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“…[141516171819] At present, there is no prospective randomized data comparing weekly and 3 weekly cisplatin in the definitive chemoradiation setting. This prospective randomized trial was conducted to compare the efficacy and toxicity of 3 weekly cisplatin at 100 mg/m 2 with weekly cisplatin at 40 mg/m 2 concurrently with radiation in locally advanced head and neck squamous cell carcinoma.…”

Section: Introductionmentioning

confidence: 99%

Phase IIb trial comparing two concurrent cisplatin schedules in locally advanced head and neck cancer

Nair

Kumar

Thomachan

et al. 2017

South Asian J Cancer

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Background: Concurrent chemoradiation with 3 weekly cisplatin (100 mg/m2) is the standard of care for locally advanced head and neck cancer. However, this regimen has been shown to be associated with lesser compliance and higher toxicities. Hence, there is a need to explore alternative concurrent cisplatin regimens. Objectives: The objective of this study was to compare the efficacy and toxicities of 3 weekly cisplatin (100 mg/m2) with weekly cisplatin (40 mg/m2) concurrently with radiation in patients with locally advanced head and neck cancer. Patients and Methods: This phase IIb trial randomized 56 patients with Stage III and IV squamous cell carcinoma of oropharynx, hypopharynx, and larynx to Arm A or Arm B. Arm A received cisplatin 100 mg/m2 3 weekly and Arm B received cisplatin 40 mg/m2 weekly concurrently with radiation. The primary end point was disease-free survival (DFS) and secondary end points were overall survival (OS) and acute toxicity. DFS and OS were estimated using Kaplan–Meier method, and log-rank test was used to assess the difference in these distributions with respect to treatment. Results: The 2-year DFS in Arm A and Arm B was 64.5% and 52.8%, respectively (P = 0.67). The OS at 2 years was 71% and 61.1% in Arm A and Arm B, respectively (P = 0.61). There were no significant differences in acute hematological, renal, or mucosal toxicities between the two arms. Conclusion: This study showed a nonsignificant improvement in DFS and OS in the 3 weekly cisplatin arm over the weekly arm with comparable toxicities. The trial is registered with Clinical Trial Registry of India (CTRI registration number: CTRI/2013/05/003703, URL-http://ctri.nic.in).

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The comparison of weekly and three-weekly cisplatin chemotherapy concurrent with radiotherapy in patients with previously untreated inoperable non-metastatic squamous cell carcinoma of the head and neck

Abstract: Comparison between two treatment modalities appears to result in statistically similar response rates and adverse event profile. A randomized phase III trial is required to confirm the safety and efficacy of weekly cisplatin therapy in patients with poor PS and/or older age at diagnosis.

Cited by 49 publications

References 20 publications

A meta-analysis of weekly cisplatin versus three weekly cisplatin chemotherapy plus concurrent radiotherapy (CRT) for advanced head and neck cancer (HNC)

A meta-analysis of weekly cisplatin versus three weekly cisplatin chemotherapy plus concurrent radiotherapy (CRT) for advanced head and neck cancer (HNC)

Pretreatment Epstein-Barr Virus DNA Load and Cumulative Cisplatin Dose Intensity Affect Long-Term Outcome of Nasopharyngeal Carcinoma Treated with Concurrent Chemotherapy: Experience of an Institute in an Endemic Area

Phase IIb trial comparing two concurrent cisplatin schedules in locally advanced head and neck cancer

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