Comparing high-dose cisplatin with cisplatin-based combination chemotherapy in definitive concurrent chemoradiation setting for locally advanced head and neck squamous cell carcinoma (LAHNSCC).

Muhammad Furqan,Travis P Snyders,Sarah L Mott,Mohammed U Saqlain,John M Watkins,Anthony Snow,Carryn M Anderson,Douglas Laux,Gerald H Clamon

doi:10.1002/cam4.2139

Muhammad Furqan, Travis P Snyders + Show 7 more

Open Access

https://doi.org/10.1002/cam4.2139

Copy DOI

Journal: Cancer medicine	Publication Date: Apr 9, 2019
Citations: 8	License type: CC BY 4.0

Affiliation: University of Iowa Hospitals and Clinics

Abstract

BackgroundHigh‐dose cisplatin (Cis) is a preferred systemic agent for concurrent chemoradiation (CRT) in locally advanced head and neck squamous cell cancer (LAHNSCC) patients. As some patients are unable to tolerate Cis, this study compares the toxicity and efficacy of weekly cisplatin‐paclitaxel (CP) regimen with Cis.MethodsPatients with LAHNSCC receiving definitive chemoradiation either with Cis (Cisplatin—100 mg/m2 q3w x 3) or CP (Cisplatin—20 mg/m2; Paclitaxel—30 mg/m2qw x7) were included.ResultsCis and CP groups were comprised of 114 and 111 subjects, respectively. Complete response for Cis versus CP groups was 88% versus 88%, respectively. Median follow‐up for the study was 58.5 months. After adjusting for potential treatment selection bias, no significant differences were evident between Cis and CP groups for overall survival (hazard ratios [HR] 0.85, 95% CI 0.59‐1.21, P = 0.36), progression free survival (HR 0.88, 95% CI 0.62‐1.24, P = 0.46), locoregional control (HR 0.77, 95% CI 0.52‐1.15, P = 0.21), and distant control (HR 0.87, 95% CI 0.61‐1.23, P = 0.42). Patients in the CP group had less acute and chronic toxicities.ConclusionsWeekly CP regimen can serve as an alternative systemic therapy with radiation in patients with LAHNSCC who are not fit for Cis.

Highlights

Head and neck squamous cell carcinoma (HNSCC) accounts for approximately 3%‐4% of all new cancer cases in the Unites States.[1]
We retrospectively explored the efficacy and toxicity of weekly CP regimen and compared it with cisplatin mg/m2 (Cis) when given concurrently with radiation for the treatment of HNSCC
Cis group included 114 patients while CP group composed of 111 patients

Summary

Introduction

Head and neck squamous cell carcinoma (HNSCC) accounts for approximately 3%‐4% of all new cancer cases in the Unites States.[1]. Regimens that were associated with benefit include platinum‐based monotherapy or polychemotherapy regimens containing platinum or fluorouracil (5‐FU) or both.[2] Due to lack of prospective data, high‐dose cisplatin 100 mg/m2 (Cis) monotherapy on days 1, 22, and 43 has been considered the preferred systemic treatment with concurrent radiation. It is an intensive regimen with considerable acute and chronic toxicities including mucositis, nausea, vomiting, myelosuppression, ototoxicity, nephrotoxicity, and neuropathy. High‐dose cisplatin (Cis) is a preferred systemic agent for concurrent chemoradiation (CRT) in locally advanced head and neck squamous cell cancer (LAHNSCC) patients.

Objectives

Methods

Results

Conclusion