Acute toxicity of three versus two courses of cisplatin for radiochemotherapy of locally advanced squamous cell carcinoma of the head and neck (SCCHN): A matched pair analysis

Abstract

This matched pair analysis compared the toxicity of two cisplatin-based radiochemotherapy regimens in patients with locally advanced (stages III or IV) squamous cell carcinoma of the head and neck (SCCHN). Two courses of fractionated cisplatin (20mg/m(2)/d1-5) given concurrently with radiotherapy are better tolerated than other common cisplatin-based regimens. However, in several countries, three courses of unfractionated cisplatin (100mg/m(2)/d1) is standard therapy. Three courses of fractionated cisplatin (20mg/m(2)/d1-5) is another option. In this prospective study, 10 consecutive patients with stage III/IV SCCHN received three courses of fractionated cisplatin (group A). These patients were matched (1:3) to 30 patients who received two courses of fractionated cisplatin (group B). The patients were matched for age, gender, performance status, tumor site, T-category, N-category, tumor stage, and surgery. At least seven factors should match between the matched patients. Because of severe acute toxicity, the planned chemotherapy could not be completed in 90% of group A and 13% of group B patients, respectively (p=0.001). At least one grade >or= 3 toxicity occurred in 90% of group A and 20% of group B patients, respectively (p=0.005). Two courses of fractionated cisplatin appeared much better tolerated than three courses of fractionated cisplatin.