Cargando…

Cisplatin Weekly Versus Every 3 Weeks Concurrently with Radiotherapy in the Treatment of Locally Advanced Head and Neck Squamous Cell Carcinomas: What Is the Best Dosing and Schedule?

PURPOSE: The aim of this prospective randomized study is to compare cisplatin at 2 dose levels given concurrently with intensity modulated radiation therapy (IMRT) in the treatment of locally advanced HNSCC. The main objectives were to evaluate treatment toxicities, loco-regional control, tumor resp...

Descripción completa

Detalles Bibliográficos
Autores principales: Mashhour, Karim, Hashem, Wedad
Formato: Online Artículo Texto
Lenguaje:English
Publicado: West Asia Organization for Cancer Prevention 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7437345/
https://www.ncbi.nlm.nih.gov/pubmed/32212810
http://dx.doi.org/10.31557/APJCP.2020.21.3.799
_version_ 1783572618736041984
author Mashhour, Karim
Hashem, Wedad
author_facet Mashhour, Karim
Hashem, Wedad
author_sort Mashhour, Karim
collection PubMed
description PURPOSE: The aim of this prospective randomized study is to compare cisplatin at 2 dose levels given concurrently with intensity modulated radiation therapy (IMRT) in the treatment of locally advanced HNSCC. The main objectives were to evaluate treatment toxicities, loco-regional control, tumor response and patients compliance. METHODS: Patients were randomized into two groups that either received 30 mg/m(2) cisplatin weekly (arm A) or 100 mg/m(2) once every 3 weeks (arm B). Radiotherapy prescribed dose was 70Gy in 33 fractions. Treatment adverse events were documented. RESULTS: Sixty patients with locally advanced HNSCC were included in this study. Recruitment started at the beginning of July 2016 and ended in July 2019. The Median follow-up was 24 months. Acute non-hematological toxicities of grade 3 or higher during the treatment course were significantly more observed in Arm B patients (76.6%) compared to Arm A patients (56.6%) with a P-value of 0.007. Hematological toxicities in the form of anemia, leucopenia and neutropenia were also significantly higher in Arm B patients with a p-value of 0.435, 0.002 and 0,002, respectively. The median 2 year loco-regional control rate in Arm B was 72.8% versus 57.6% in Arm A with a p-value of 0.015. Complete responses were similar between both groups (77%). Compliance to treatment was better in Arm A with 70% of the patients received at least 6 weekly doses where as 60% of the patients in Arm B completed the three cycles of treatment and 40 % received only 2 cycles. CONCLUSION: Once weekly low dose cisplatin treatment showed lower acute toxicity and a better compliance compared to once every 3 weeks high dose cisplatin treatment at the expense of a lower loco-regional control.
format Online
Article
Text
id pubmed-7437345
institution National Center for Biotechnology Information
language English
publishDate 2020
publisher West Asia Organization for Cancer Prevention
record_format MEDLINE/PubMed
spelling pubmed-74373452020-09-02 Cisplatin Weekly Versus Every 3 Weeks Concurrently with Radiotherapy in the Treatment of Locally Advanced Head and Neck Squamous Cell Carcinomas: What Is the Best Dosing and Schedule? Mashhour, Karim Hashem, Wedad Asian Pac J Cancer Prev Research Article PURPOSE: The aim of this prospective randomized study is to compare cisplatin at 2 dose levels given concurrently with intensity modulated radiation therapy (IMRT) in the treatment of locally advanced HNSCC. The main objectives were to evaluate treatment toxicities, loco-regional control, tumor response and patients compliance. METHODS: Patients were randomized into two groups that either received 30 mg/m(2) cisplatin weekly (arm A) or 100 mg/m(2) once every 3 weeks (arm B). Radiotherapy prescribed dose was 70Gy in 33 fractions. Treatment adverse events were documented. RESULTS: Sixty patients with locally advanced HNSCC were included in this study. Recruitment started at the beginning of July 2016 and ended in July 2019. The Median follow-up was 24 months. Acute non-hematological toxicities of grade 3 or higher during the treatment course were significantly more observed in Arm B patients (76.6%) compared to Arm A patients (56.6%) with a P-value of 0.007. Hematological toxicities in the form of anemia, leucopenia and neutropenia were also significantly higher in Arm B patients with a p-value of 0.435, 0.002 and 0,002, respectively. The median 2 year loco-regional control rate in Arm B was 72.8% versus 57.6% in Arm A with a p-value of 0.015. Complete responses were similar between both groups (77%). Compliance to treatment was better in Arm A with 70% of the patients received at least 6 weekly doses where as 60% of the patients in Arm B completed the three cycles of treatment and 40 % received only 2 cycles. CONCLUSION: Once weekly low dose cisplatin treatment showed lower acute toxicity and a better compliance compared to once every 3 weeks high dose cisplatin treatment at the expense of a lower loco-regional control. West Asia Organization for Cancer Prevention 2020-03 /pmc/articles/PMC7437345/ /pubmed/32212810 http://dx.doi.org/10.31557/APJCP.2020.21.3.799 Text en This is an Open Access article distributed under the terms of the Creative Commons Attribution License, (http://creativecommons.org/licenses/by/3.0/) which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Research Article
Mashhour, Karim
Hashem, Wedad
Cisplatin Weekly Versus Every 3 Weeks Concurrently with Radiotherapy in the Treatment of Locally Advanced Head and Neck Squamous Cell Carcinomas: What Is the Best Dosing and Schedule?
title Cisplatin Weekly Versus Every 3 Weeks Concurrently with Radiotherapy in the Treatment of Locally Advanced Head and Neck Squamous Cell Carcinomas: What Is the Best Dosing and Schedule?
title_full Cisplatin Weekly Versus Every 3 Weeks Concurrently with Radiotherapy in the Treatment of Locally Advanced Head and Neck Squamous Cell Carcinomas: What Is the Best Dosing and Schedule?
title_fullStr Cisplatin Weekly Versus Every 3 Weeks Concurrently with Radiotherapy in the Treatment of Locally Advanced Head and Neck Squamous Cell Carcinomas: What Is the Best Dosing and Schedule?
title_full_unstemmed Cisplatin Weekly Versus Every 3 Weeks Concurrently with Radiotherapy in the Treatment of Locally Advanced Head and Neck Squamous Cell Carcinomas: What Is the Best Dosing and Schedule?
title_short Cisplatin Weekly Versus Every 3 Weeks Concurrently with Radiotherapy in the Treatment of Locally Advanced Head and Neck Squamous Cell Carcinomas: What Is the Best Dosing and Schedule?
title_sort cisplatin weekly versus every 3 weeks concurrently with radiotherapy in the treatment of locally advanced head and neck squamous cell carcinomas: what is the best dosing and schedule?
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7437345/
https://www.ncbi.nlm.nih.gov/pubmed/32212810
http://dx.doi.org/10.31557/APJCP.2020.21.3.799
work_keys_str_mv AT mashhourkarim cisplatinweeklyversusevery3weeksconcurrentlywithradiotherapyinthetreatmentoflocallyadvancedheadandnecksquamouscellcarcinomaswhatisthebestdosingandschedule
AT hashemwedad cisplatinweeklyversusevery3weeksconcurrentlywithradiotherapyinthetreatmentoflocallyadvancedheadandnecksquamouscellcarcinomaswhatisthebestdosingandschedule