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Randomized trial on acute toxicities of weekly vs three‐weekly cisplatin‐based chemoradiation in head and neck cancer
BACKGROUND: The current first‐line treatment of locally advanced head and neck carcinoma (LAHNC) is concurrent chemoradiation with three‐weekly cisplatin 100 mg/m(2). However, prescribing cisplatin at this dose increases the treatment toxicity, which may compromise the treatment results. An alternat...
Autores principales: | , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
John Wiley and Sons Inc.
2021
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8789619/ https://www.ncbi.nlm.nih.gov/pubmed/34101389 http://dx.doi.org/10.1002/cnr2.1425 |
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author | Ameri, Ahmad Norouzi, Shokoufe Sourati, Ainaz Azghandi, Samira Novin, Kambiz Taghizadeh‐Hesary, Farzad |
author_facet | Ameri, Ahmad Norouzi, Shokoufe Sourati, Ainaz Azghandi, Samira Novin, Kambiz Taghizadeh‐Hesary, Farzad |
author_sort | Ameri, Ahmad |
collection | PubMed |
description | BACKGROUND: The current first‐line treatment of locally advanced head and neck carcinoma (LAHNC) is concurrent chemoradiation with three‐weekly cisplatin 100 mg/m(2). However, prescribing cisplatin at this dose increases the treatment toxicity, which may compromise the treatment results. An alternative schedule is weekly 40 mg/m(2) cisplatin. AIM: To compare the acute hematologic and renal toxicities of these two regimens. METHODS: This randomized clinical trial included 77 LAHNC patients who were allocated to a high dose (100 mg/m(2) every 3 weeks) or low dose (40 mg/m(2) weekly) cisplatin group concurrent with radiotherapy. Hematologic and renal indices were measured weekly during chemoradiation. RESULTS: The average age of patients was 55.3 years. Overall, 71.4% of patients were treated in a definitive setting. The incidence of severe hematologic events was not significantly different. However, the average estimated glomerular filtration rate (eGFR) was significantly greater in the three‐weekly group (67.85 vs. 58.57% mL/min per 1.73 m(2); P‐value = .02). Cumulative cisplatin dose of ≥240 mg/m(2) was significantly greater in the weekly group. Totally, treatment breaks occurred in 40.3% of patients due to treatment toxicity. Treatment interruption was primarily due to neutropenia in the three‐weekly and renal dysfunction and thrombocytopenia in the weekly group. CONCLUSIONS: Severe acute hematologic toxicities were comparable for three‐weekly and weekly groups. The decrease in eGFR through treatment was more significant with weekly cisplatin. Further follow‐up, however, is needed to confirm its impact on delayed renal function. |
format | Online Article Text |
id | pubmed-8789619 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2021 |
publisher | John Wiley and Sons Inc. |
record_format | MEDLINE/PubMed |
spelling | pubmed-87896192022-02-01 Randomized trial on acute toxicities of weekly vs three‐weekly cisplatin‐based chemoradiation in head and neck cancer Ameri, Ahmad Norouzi, Shokoufe Sourati, Ainaz Azghandi, Samira Novin, Kambiz Taghizadeh‐Hesary, Farzad Cancer Rep (Hoboken) Clinical Trial BACKGROUND: The current first‐line treatment of locally advanced head and neck carcinoma (LAHNC) is concurrent chemoradiation with three‐weekly cisplatin 100 mg/m(2). However, prescribing cisplatin at this dose increases the treatment toxicity, which may compromise the treatment results. An alternative schedule is weekly 40 mg/m(2) cisplatin. AIM: To compare the acute hematologic and renal toxicities of these two regimens. METHODS: This randomized clinical trial included 77 LAHNC patients who were allocated to a high dose (100 mg/m(2) every 3 weeks) or low dose (40 mg/m(2) weekly) cisplatin group concurrent with radiotherapy. Hematologic and renal indices were measured weekly during chemoradiation. RESULTS: The average age of patients was 55.3 years. Overall, 71.4% of patients were treated in a definitive setting. The incidence of severe hematologic events was not significantly different. However, the average estimated glomerular filtration rate (eGFR) was significantly greater in the three‐weekly group (67.85 vs. 58.57% mL/min per 1.73 m(2); P‐value = .02). Cumulative cisplatin dose of ≥240 mg/m(2) was significantly greater in the weekly group. Totally, treatment breaks occurred in 40.3% of patients due to treatment toxicity. Treatment interruption was primarily due to neutropenia in the three‐weekly and renal dysfunction and thrombocytopenia in the weekly group. CONCLUSIONS: Severe acute hematologic toxicities were comparable for three‐weekly and weekly groups. The decrease in eGFR through treatment was more significant with weekly cisplatin. Further follow‐up, however, is needed to confirm its impact on delayed renal function. John Wiley and Sons Inc. 2021-06-07 /pmc/articles/PMC8789619/ /pubmed/34101389 http://dx.doi.org/10.1002/cnr2.1425 Text en © 2021 The Authors. Cancer Reports published by Wiley Periodicals LLC. https://creativecommons.org/licenses/by/4.0/This is an open access article under the terms of the http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited. |
spellingShingle | Clinical Trial Ameri, Ahmad Norouzi, Shokoufe Sourati, Ainaz Azghandi, Samira Novin, Kambiz Taghizadeh‐Hesary, Farzad Randomized trial on acute toxicities of weekly vs three‐weekly cisplatin‐based chemoradiation in head and neck cancer |
title | Randomized trial on acute toxicities of weekly vs three‐weekly cisplatin‐based chemoradiation in head and neck cancer |
title_full | Randomized trial on acute toxicities of weekly vs three‐weekly cisplatin‐based chemoradiation in head and neck cancer |
title_fullStr | Randomized trial on acute toxicities of weekly vs three‐weekly cisplatin‐based chemoradiation in head and neck cancer |
title_full_unstemmed | Randomized trial on acute toxicities of weekly vs three‐weekly cisplatin‐based chemoradiation in head and neck cancer |
title_short | Randomized trial on acute toxicities of weekly vs three‐weekly cisplatin‐based chemoradiation in head and neck cancer |
title_sort | randomized trial on acute toxicities of weekly vs three‐weekly cisplatin‐based chemoradiation in head and neck cancer |
topic | Clinical Trial |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8789619/ https://www.ncbi.nlm.nih.gov/pubmed/34101389 http://dx.doi.org/10.1002/cnr2.1425 |
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