Concomitant Chemoradiotherapy with Altered Cisplatin Regimen in Management of Locally Advanced Head and Neck Cancers

Abstract Purpose: Evaluation the tolerability, toxicity profile, and the outcome of treating locally advanced squamous cell carcinoma of the head and neck with altered cisplatin dose regimen concomitantly with radiotherapy. Materials and methods: This study was based on a retrospective analysis of 48 patients treated with Concomitant Chemoradiotherapy (CCRT) using fractionated cisplatin doses of 20 mg/m2 from days 1 to 5 in the first and fifth weeks of radiotherapy. The follow-up was performed during the treatment and four weeks after the end of radiation in cooperation with the Otorhinolaryngology department. Results: 45 patients (93.8%) out all 48 completed the whole treatment protocol. The incidence of grade II or acute toxicities were: mucositis 64.6%, dysphagia 50% and grade II or III haematological events 14.6%. The late toxicities included: Xerostomia 33.3% dysphagia 29.2% trismus 14.6% deafness 14.6% dysgeusia 16.7%. The median follow-up time was 3.7 years after the treatment. 15 patients (31.3%) experienced recurrences and the 2- year disease free survival (DFS) was 70.8%. The 2-year overall survival (OS) was 85.4% among all patients. Conclusion: The studied altered cisplatin protocol shows higher compliance and tolerability in comparison to the standard high cisplatin schedule and similar to the weekly one. Regarding the OS and DFS, the study shows comparable results with other cisplatin regimens. However, further phase III randomized multicentre studies are required to determine the most effective and least toxic cisplatin regimen in head and neck cancer patients treated with CCRT.

Author(s): Abdelmaqsoud A , Mueller AH, Knips M and Bank P

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