Hostname: page-component-78c5997874-m6dg7 Total loading time: 0 Render date: 2024-11-04T18:26:49.829Z Has data issue: false hasContentIssue false
  • English
  • Français

Compliance, toxicity and efficacy in weekly versus 3-weekly cisplatin concurrent chemoradiation in locally advanced head and neck cancer

Published online by Cambridge University Press:  04 September 2018

Sandeep Muzumder Open the ORCID record for Sandeep Muzumder [Opens in a new window] ,
Nirmala Srikantia ,
Ganesha Dev Vashishta ,
Avinash H. Udayashankar ,
John Michael Raj ,
M. G. John Sebastian  and
Prashanth Bhat Kainthaje
Sandeep Muzumder*
Affiliation:
Department of Radiation Oncology, St. John’s Medical College and Hospital, Bengaluru, Karnataka, India
Nirmala Srikantia
Affiliation:
Department of Radiation Oncology, St. John’s Medical College and Hospital, Bengaluru, Karnataka, India
Ganesha Dev Vashishta
Affiliation:
St. John’s Medical College and Hospital, Bengaluru, Karnataka, India
Avinash H. Udayashankar
Affiliation:
Department of Radiation Oncology, St. John’s Medical College and Hospital, Bengaluru, Karnataka, India
John Michael Raj
Affiliation:
Department of Biostatistics, St John’s Medical College, Bengaluru, Karnataka, India
M. G. John Sebastian
Affiliation:
Department of Radiation Oncology, St. John’s Medical College and Hospital, Bengaluru, Karnataka, India
Prashanth Bhat Kainthaje
Affiliation:
Department of Radiation Oncology, St. John’s Medical College and Hospital, Bengaluru, Karnataka, India
*
Author for correspondence: Dr Sandeep Muzumder, Department of Radiation Oncology, St. John’s Medical College and Hospital, Sarjapur Road, Bengaluru, Karnataka 560034, India. Tel: +91 974 215 7090. E-mail: [email protected]
Get access Rights & Permissions [Opens in a new window]

Abstract

Aim

Weekly low-dose cisplatin is routinely used in concurrent chemoradiation (CCRT) in locally advanced head and neck cancer (LAHNC), despite 3-weekly cisplatin being the standard of care. We compared compliance, toxicity and efficacy in weekly versus 3-weekly cisplatin CCRT in LAHNC.

Materials and methods

In this retrospective study, weekly cisplatin 50 mg flat dose was compared with 3-weekly cisplatin 100 mg/m2, when given in CCRT in LAHNC with curative intent. The study outcome was compliance, toxicity, loco-regional control (LRC), disease-free survival (DFS) and overall survival (OS).

Results

Eighty-four patients received CCRT from January 2013 to June 2017, 40 in weekly and 44 in 3-weekly arm. There was no difference between the arms not completing scheduled radiation therapy or chemotherapy. Patient receiving 200 mg/m2 cisplatin is higher in 3-weekly arm compared with weekly arm (75 versus 40·9%; p<0·0015). Compared with 3-weekly arm, more patient in weekly arm developed grade ≥3 mucositis (52·5 versus 15·9%, p=0·0004), day care intravenous hydration (82·5 versus 38·6% <0·0001) and in-patient admission (55·0 versus 18·2%; p=0·0004). The 2-year LRC, DFS and OS in weekly versus 3-weekly arm were: 70 versus 61·4% (p=0·406); 67·5 versus 56·8% (p=0·314); 67·5 versus 61·4% (p=0·558), respectively. The median time to LRR, DFs and OS was not reached.

Conclusions

Weekly cisplatin is comparable with 3-weekly cisplatin in terms of compliance, disease control and survival, but with increased grade 3 mucositis and higher admissions for supportive care.

Keywords

3-weekly chemotherapycisplatinconcurrent chemoradiationhead and neck cancerweekly chemotherapy
Type
Original Article
Information
Journal of Radiotherapy in Practice , Volume 18 , Issue 1 , March 2019 , pp. 21 - 25
Copyright
© Cambridge University Press 2018 

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

Footnotes

Cite this article: Muzumder S, Srikantia N, Vashishta GD, Udayashankar AH, Raj JM, Sebastian MGJ, Kainthaje PB. (2019) Compliance, toxicity and efficacy in weekly versus 3-weekly cisplatin concurrent chemoradiation in locally advanced head and neck cancer. Journal of Radiotherapy in Practice18: 21–25. doi: 10.1017/S1460396918000341

References

1. Pignon, J P, le Maître, A, Maillard, E, Bourhis, J, on behalf of the MACH-NC Collaborative Group. Meta-analysis of chemotherapy in head and neck cancer (MACH-NC): an update on 93 randomised trials and 17,346 patients. Radiother Oncol 2009; 92: 4–14.Google Scholar
2. Bernier, J, Domenge, C, Ozsahin, M et al. European Organization for Research and Treatment of Cancer Trial 22931. Postoperative irradiation with or without concomitant chemotherapy for locally advanced head and neck cancer. N Engl J Med 2004; 350: 1945–1952.Google Scholar
3. Cooper, J S, Pajak, T F, Forastiere, A A et al. Radiation Therapy Oncology Group 9501/Intergroup. Postoperative concurrent radiotherapy and chemotherapy for high-risk squamous-cell carcinoma of the head and neck. N Engl J Med 2004; 350: 1937–1944.Google Scholar
4. Mirabile, A, Numico, G, Russi, E G et al. Sepsis in head and neck cancer patients treated with chemotherapy and radiation: literature review and consensus. Crit Rev Oncol Hematol 2015; 95: 191–213.Google Scholar
5. Gupta, T, Kannan, S, Ghosh-Laskar, S, Agarwal, J P. Systematic review and meta-analysis of conventionally fractionated concurrent chemoradiotherapy versus altered fractionation radiotherapy alone in the definitive management of locoregionally advanced head and neck squamous cell carcinoma. Clin Oncol (R Coll Radiol) 2016; 28: 50–61.Google Scholar
6. Guan, J, Li, Q, Zhang, Y et al. A meta-analysis comparing cisplatin-based to carboplatin-based chemotherapy in moderate to advanced squamous cell carcinoma of head and neck (SCCHN). Oncotarget 2016; 7 (6): 7110–7119.Google Scholar
7. Fayette, J, Molin, Y, Lavergne, E et al. Radiotherapy potentiation with weekly cisplatin compared to standard every 3 weeks cisplatin chemotherapy for locoregionally advanced head and neck squamous cell carcinoma. Drug Des Devel Ther 2015; 9: 6203–6210.Google Scholar
8. Espeli, V, Zucca, E, Ghielmini, M et al. Weekly and 3-weekly cisplatin concurrent with intensity-modulated radiotherapy in locally advanced head and neck squamous cell cancer. Oral Oncol 2012; 48: 266–271.Google Scholar
9. Gupta, T, Agarwal, JP, Ghosh-Laskar, S, Parikh, PM, D’Cruz, AK, Dinshaw, KA. Radical radiotherapy with concurrent weekly cisplatin in loco-regionally advanced squamous cell carcinoma of the head and neck: a single-institution experience. Head Neck Oncol 2009; 1: 17.Google Scholar
10. Guan, J, Zhang, Y, Li, Q et al. A meta-analysis of weekly cisplatin versus three weekly cisplatin chemotherapy plus concurrent radiotherapy (CRT) for advanced head and neck cancer (HNC). Oncotarget 2016; 7: 70185–70193.Google Scholar
11. Noronha, V, Joshi, A, Patil, VM et al. Once-a-week versus once-every-3-weeks cisplatin chemoradiation for locally advanced head and neck cancer: a phase III randomized noninferiority trial. J Clin Oncol 2018; 36: 1064–1072.Google Scholar
12. Edge, SB, Byrd, DR, Compton, CC, Fritz, AG, Greene, FL, Trotti, A. (eds) AJCC Cancer Staging Manual, 7th edition. American Joint Committee on Cancer. Chicago, IL: Springer, 2010.Google Scholar
13. Rawat, S, Srivastava, H, Ahlawat, P et al. Weekly versus three-weekly cisplatin-based concurrent chemoradiotherapy as definitive treatment in head and neck cancer - where do we stand? Gulf J Oncol 2016; 21: 6–11.Google Scholar
14. Szturz, P, Wouters, K, Kiyota, N et al. Weekly low-dose versus three-weekly high-dose cisplatin for concurrent chemoradiation in locoregionally advanced non-nasopharyngeal head and neck cancer: a systematic review and meta-analysis of aggregate data. Oncologist 2017; 22: 1056–1066.Google Scholar
15. Chang, CL, Yuan, KS, Wu, SY. High-dose or low-dose cisplatin concurrent with radiotherapy in locally advanced head and neck squamous cell cancer. Head Neck 2017; 39: 1364–1370.Google Scholar