Efficacy and tolerability of weekly low-dose cisplatin concurrent with radiotherapy in head and neck cancer patients.

AIMS

In this retrospective analysis, we describe the efficacy and tolerability of weekly cisplatin 40 mg/m(2) used in concurrent chemoradiation of head and neck cancer at the Townsville Cancer Centre.

METHODS

Review of medical records of patients who received radical chemoradiotherapy for head and neck cancer at Townsville Cancer Centre from 2003 to 2009.

RESULTS

In all 102 patients were analysed, 62 of whom had definitive chemoradiation and the remainder adjuvant chemoradiotherapy. Median follow up was 20.1 months (range 5-86 months). Overall 68.6% of patients received 5 weeks or more of planned chemotherapy. Radiotherapy interruptions occurred in four (6.4%) patients. The rate of grade 3-4 adverse events was 51% including neutropenia (18.6%), mucositis (21.8%) and dysphagia (12.9%) and 30.7% of patients needed hospital admission to manage toxicities. For definitive and adjuvant groups, estimated 3-year survival was 64.5 and 71.5%, respectively, and estimated 3-year disease-specific survival rates were 70.3 and 81.6%, respectively. The 3-year overall survival for patients who received five or more cycles of chemotherapy was 75.2%, compared to 52.6% for those receiving fewer than five cycles (P = 0.018).

CONCLUSION

Despite this is being a small retrospective study, survival figures and toxicity profiles of low dose weekly cisplatin are comparable to historical controls using high-dose regimens, hence justifying our approach. In addition, radiotherapy interruptions are minimized and cisplatin is easy to administer in outpatient settings. Future three-arm studies could include this regimen as the basis of treatment combined with targeted therapies.