Abstract
BackgroundThe aim of this study was to compare the outcomes of postoperative adjuvant concomitant chemoradiotherapy using two different schedules of cisplatin for patients with high-risk oral squamous cell carcinoma (OSCC).MethodsFrom Feb. 2008 to Aug. 2010, 55 patients with high-risk OSCC were included in this study. Patients were randomized into treatment groups that either received 100 mg/m2 cisplatin once every 3 weeks (arm A) or 40 mg/m2 cisplatin once per week (arm B). All patients were irradiated with 66 Gy in 33 fractions.ResultsOf the 50 eligible patients, 26 were assigned to arm A, and 24 were assigned to arm B. Both groups of patients received the same mean doses of radiotherapy and cisplatin. However, 88.5% of patients in arm A and 62.5% of those in arm B (p = 0.047) received ≥ 200 mg/m2 of cisplatin in total. The overall toxicity was significantly greater in arm B (p = 0.020), and all of the grade 4 toxicities occurred in patients in arm B.ConclusionsThree-weekly high-dose cisplatin treatment showed higher compliance, and lower acute toxicity compared to weekly low-dose cisplatin treatment.
Highlights
The aim of this study was to compare the outcomes of postoperative adjuvant concomitant chemoradiotherapy using two different schedules of cisplatin for patients with high-risk oral squamous cell carcinoma (OSCC)
Patients with pathologically documented extracapsular spreading (ECS) of the involved lymph node (LN), a positive surgical margin, or those with LN staging ≥ N2 are at high risk for therapeutic failure
Of the 5 patients excluded, 4 did not completely satisfy the inclusion criteria, as 2 patients had previously been treated for primary head and neck malignancies, 1 patient had a pathology indicative of myoepithelial carcinoma instead of SCCHN, and 1 patient was found to have no major pathologic risk factors, such as ECS of the involved LN, a positive surgical margin, or LN staging ≥ N2
Summary
The aim of this study was to compare the outcomes of postoperative adjuvant concomitant chemoradiotherapy using two different schedules of cisplatin for patients with high-risk oral squamous cell carcinoma (OSCC). Surgery is the primary therapeutic treatment options for locally advanced oral cavity squamous cell carcinoma (OSCC). Several other chemotherapy regimens for CCRT use a different schedule of cisplatin to improve compliance and the toxicity profile. Among these regimens, weekly cisplatin doses ranging from 30 to 40 mg/m2 are used most widely in the radical and adjuvant settings [4,5,6]
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