Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Multicenter Study
. 2019 Feb 11;14(1):32.
doi: 10.1186/s13014-019-1235-y.

3-weekly or weekly cisplatin concurrently with radiotherapy for patients with squamous cell carcinoma of the head and neck - a multicentre, retrospective analysis

Seth Helfenstein  1 , Oliver Riesterer  2 , Urs R Meier  3 , Alexandros Papachristofilou  4 , Benjamin Kasenda  1 , Miklos Pless  5 , Sacha I Rothschild  6
Affiliations
Multicenter Study

3-weekly or weekly cisplatin concurrently with radiotherapy for patients with squamous cell carcinoma of the head and neck - a multicentre, retrospective analysis

Seth Helfenstein et al. Radiat Oncol. .

Abstract

Background: Concurrent chemoradiotherapy with cisplatin is standard for patients (pts) with loco-regionally advanced squamous cell carcinoma of the head and neck (LA-SCCHN) and for patients with resected SCCHN with high-risk features. The standard regimen includes 3-weekly cisplatin, but weekly regimens are often used to lower toxicity. Reaching a cumulative dose of ≥200 mg/m2 cisplatin was shown being associated with improved outcome. We herein investigated cumulative dose reached and toxicities between the 3-weekly and weekly cisplatin regimens with concurrent radiotherapy.

Methods: Multicentre, retrospective analysis of all patients undergoing combined RCT with cisplatin treated at 3 centres in Switzerland between 06/2008 and 12/2015.

Results: Three hundred fourteen pts. were included (3-weekly, N = 127; weekly, N = 187). Median cumulative cisplatin dose was 200 mg/m2 (IQR 150-300) for pts. treated with a 3-weekly schedule and 160 mg/m2 (120-240) for the weekly schedule, consequently more pts. treated with a 3-weekly schedule reached a cumulative dose ≥200 mg/m2 (75.6% vs. 47.1%, p < 0.001). This association was also observed in multivariable analysis adjusted for age and sex (OR 3.46, 95% confidence interval [CI], 2.1-5.7). The 3-weekly regimen led to a higher rate of acute renal toxicity (33.1% vs. 20.9%, p = 0.022). In the landmark analysis, we could not confirm that a cisplatin dose ≥200 mg/m2 is associated with better survival (HR 1.3, 95% CI 0.8-1.9).

Conclusions: Significantly more patients receive a cumulative cisplatin dose of ≥200 mg/m2, when treated with a 3-weekly schedule compared to weekly dosing. The previously reported association between a cumulative cisplatin dose ≥200 mg/m2 and improved outcome could not be shown in our study.

Keywords: Chemo-radiotherapy; Cisplatin; Dose; Head and neck squamous carcinoma; Treatment.

PubMed Disclaimer

Conflict of interest statement

Ethics approval and consent to participate

This study was performed in accordance with institutional review board approval by the local ethical committees (ethical committee of northwestern and central part of Switzerland, (EKNZ) and cantonal ethical committee Zurich (KEK), approval number 2016–01062).

Consent for publication

Not applicable.

Competing interests

The authors declare that they have no competing interests.

Publisher’s Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Figures

Fig. 1
Fig. 1
Cumulative cisplatin dose with a cut-off dose of 200 mg/m2 comparing 3-weekly vs. weekly schedule
Fig. 2
Fig. 2
Comparison of treatment regimens (3-weely vs. weekly cisplatin) for progression-free survival (landmark analysis)
Fig. 3
Fig. 3
Comparison of treatment regimens (3-weely vs. weekly cisplatin) for overall survival (landmark analysis)
See this image and copyright information in PMC

References

    1. Rodriguez CP, Adelstein DJ. Survival trends in head and neck Cancer: opportunities for improving outcomes. Oncologist. 2010;15:921–923. doi: 10.1634/theoncologist.2010-0237. - DOI - PMC - PubMed
    1. Jakobsen KK, Grønhøj C, Jensen DH, Karnov KKS, Agander TK, Specht L, et al. Increasing incidence and survival of head and neck cancers in Denmark: a nation-wide study from 1980 to 2014. Acta Oncol (Madr). 2018:1–9. - PubMed
    1. Megwalu UC, Sirjani D, Devine EE. Oropharyngeal squamous cell carcinoma incidence and mortality trends in the United States, 1973-2013. Laryngoscope. 2018;128:1582–1588. doi: 10.1002/lary.26972. - DOI - PubMed
    1. Chaturvedi AK, Engels EA, Pfeiffer RM, Hernandez BY, Xiao W, Kim E, et al. Human papillomavirus and rising oropharyngeal Cancer incidence in the United States. J Clin Oncol. 2011;29:4294–4301. doi: 10.1200/JCO.2011.36.4596. - DOI - PMC - PubMed
    1. Adelstein DJ, Li Y, Adams GL, Wagner H, Jr, Kish JA, Ensley JF, et al. An intergroup phase III comparison of standard radiation therapy and two schedules of concurrent chemoradiotherapy in patients with unresectable squamous cell head and neck cancer. J Clin Oncol. 2003;21:92–98. doi: 10.1200/JCO.2003.01.008. - DOI - PubMed

Publication types

LinkOut - more resources