3-weekly or weekly cisplatin concurrently with radiotherapy for patients with squamous cell carcinoma of the head and neck – a multicentre, retrospective analysis
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 wee...
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| Format: | Article |
| Language: | English |
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BMC
2019-02-01
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| Series: | Radiation Oncology |
| Subjects: | |
| Online Access: | http://link.springer.com/article/10.1186/s13014-019-1235-y |
| _version_ | 1828887759998156800 |
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| author | Seth Helfenstein Oliver Riesterer Urs R. Meier Alexandros Papachristofilou Benjamin Kasenda Miklos Pless Sacha I. Rothschild |
| author_facet | Seth Helfenstein Oliver Riesterer Urs R. Meier Alexandros Papachristofilou Benjamin Kasenda Miklos Pless Sacha I. Rothschild |
| author_sort | Seth Helfenstein |
| collection | DOAJ |
| description | 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. |
| first_indexed | 2024-12-13T12:10:21Z |
| format | Article |
| id | doaj.art-4ffba49eaed84a588201c38e9e8fd591 |
| institution | Directory Open Access Journal |
| issn | 1748-717X |
| language | English |
| last_indexed | 2024-12-13T12:10:21Z |
| publishDate | 2019-02-01 |
| publisher | BMC |
| record_format | Article |
| series | Radiation Oncology |
| spelling | doaj.art-4ffba49eaed84a588201c38e9e8fd5912022-12-21T23:46:51ZengBMCRadiation Oncology1748-717X2019-02-0114111010.1186/s13014-019-1235-y3-weekly or weekly cisplatin concurrently with radiotherapy for patients with squamous cell carcinoma of the head and neck – a multicentre, retrospective analysisSeth Helfenstein0Oliver Riesterer1Urs R. Meier2Alexandros Papachristofilou3Benjamin Kasenda4Miklos Pless5Sacha I. Rothschild6Department Internal Medicine, University Hospital BaselClinic for Radiation Oncology, University Hospital and University of ZürichCantonal Hospital Winterthur, Clinic for Radiation OncologyClinic for Radiotherapy and Radio-Oncology, University Hospital BaselDepartment Internal Medicine, University Hospital BaselMedical Oncology, Cantonal Hospital WinterthurDepartment Internal Medicine, University Hospital BaselAbstract 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.http://link.springer.com/article/10.1186/s13014-019-1235-yHead and neck squamous carcinomaChemo-radiotherapyTreatmentCisplatinDose |
| spellingShingle | Seth Helfenstein Oliver Riesterer Urs R. Meier Alexandros Papachristofilou Benjamin Kasenda Miklos Pless Sacha I. Rothschild 3-weekly or weekly cisplatin concurrently with radiotherapy for patients with squamous cell carcinoma of the head and neck – a multicentre, retrospective analysis Radiation Oncology Head and neck squamous carcinoma Chemo-radiotherapy Treatment Cisplatin Dose |
| title | 3-weekly or weekly cisplatin concurrently with radiotherapy for patients with squamous cell carcinoma of the head and neck – a multicentre, retrospective analysis |
| title_full | 3-weekly or weekly cisplatin concurrently with radiotherapy for patients with squamous cell carcinoma of the head and neck – a multicentre, retrospective analysis |
| title_fullStr | 3-weekly or weekly cisplatin concurrently with radiotherapy for patients with squamous cell carcinoma of the head and neck – a multicentre, retrospective analysis |
| title_full_unstemmed | 3-weekly or weekly cisplatin concurrently with radiotherapy for patients with squamous cell carcinoma of the head and neck – a multicentre, retrospective analysis |
| title_short | 3-weekly or weekly cisplatin concurrently with radiotherapy for patients with squamous cell carcinoma of the head and neck – a multicentre, retrospective analysis |
| title_sort | 3 weekly or weekly cisplatin concurrently with radiotherapy for patients with squamous cell carcinoma of the head and neck a multicentre retrospective analysis |
| topic | Head and neck squamous carcinoma Chemo-radiotherapy Treatment Cisplatin Dose |
| url | http://link.springer.com/article/10.1186/s13014-019-1235-y |
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