AOSP16 COMPARISON OF ACUTE TOXICITY PROFILE OF WEEKLY VERSUS 3-WEEKLY CISPLATIN IN CONCURRENT CHEMORADIATION FOR LOCALLY ADVANCED HEAD AND NECK SQUAMOUS CELL CARCINOMA

Abstract

Introduction. Concurrent chemoradiation is one of the standards of care in locally advanced head and neck squamous cell carcinoma (LAHNSCC). Single agent cisplatin once every 3weeks alongwith radiotherapy is themostwidely accepted chemoradiotherapy regimen. However, weekly cisplatin provides more dose intensity and is purported to have better tolerability. Methods. Between June 2010 and March 2011, 66 patients with LAHNSCC and for whom chemoradiotherapy was planned were randomised to receive either cisplatin 80mg/m2 every 3 weeks (arm 1) or ciplatin 40mg/m2 every week (arm 2). All patients received radical radiotherapy (66−70Gy). Acute toxicities of radiotherapy and chemotherapy were assessed weekly, using Radiotherapy and Oncology Group and National Cancer Institute Common Toxicity Criteria, respectively. Results. Thirty-five patients received the 3-weekly regimen and 31 patients received the weekly regimen. Patient characteristics were balanced in both arms. Compliance with radiotherapy was equal in both arms (90%). Mean dose of cisplatin was 160mg/m2 in the 3-weekly arm and 181mg/m2 in the weekly arm. Only 23% of the patients in the 3-weekly arm and 26% in theweekly arm received all the planned cycles of chemotherapy. A higher dose of cisplatin was delivered (above 200mg/m2) in the weekly arm (71% vs 23%; p=0.001). Grade 2 vomiting was significantly higher in the 3-weekly arm (10% vs 0%; p=0.025).There was no difference in odynophagia, skin toxicity, mucositis, use of analgesics, or haematological toxicity. Discussion. Compliance with treatment and acute toxicities were similar in both arms except for vomiting, which was higher in the 3-weekly regimen. Approximately 25% of patients completed the planned chemotherapy cycles in both arms. Cumulative dose of cisplatin was higher in the weekly arm. Small sample size is a limitation of this study and efficacy data are awaited. Funding. None. The authors declared no conflicts of interest.