Perez Cesar Augusto, Wu Xiaoyong, Amsbaugh Mark J, Gosain Rahul, Claudino Wederson M, Yusuf Mehran, Roberts Teresa, Jain Dharamvir, Jenson Alfred, Khanal Sujita, Silverman Craig I, Tennant Paul, Bumpous Jeffrey M, Dunlap Neal E, Rai Shesh N, Redman Rebecca A
Division of Medical Oncology and Hematology, James Graham Brown Cancer Center, University of Louisville, Louisville, KY, United States.
Biostatistics Shared Facility, JG Brown Cancer Center, University of Louisville, KY, United States.
Oral Oncol. 2017 Apr;67:24-28. doi: 10.1016/j.oraloncology.2017.01.010. Epub 2017 Feb 3.
To compare the outcomes and toxicity of high-dose cisplatin (HDC) versus weekly cisplatin (WC) definitive chemoradiotherapy (CRT) for patients with human papillomavirus (HPV) related oropharyngeal squamous cell carcinoma (SCCOPx).
All patients with p16 positive SCCOPx treated with definitive CRT with cisplatin between 2010 and 2014 at a single institution were retrospectively reviewed. CTCAE v 4.03 toxicity criteria were used. The Kaplan-Meier method was used to estimate event-free survival (EFS) and the overall survival (OS).
Of the 55 patients included, 22 were patients treated with HDC at dose of 100mg/m on days 1 and 22; and the remaining 33 patients were treated with WC at 40mg/m. Both cohorts received a median total dose of cisplatin of 200mg/m. At median follow-up of 31months, there was one local failure and no distant failures in the HDC cohort. In the WC group, there were 6 total failures (2 local, 4 distant). Estimated 2-year EFS was better in HDC cohort as compared to WC (96% vs. 75%; p=0.04). There was no significant difference in 2-year OS (95% vs. 94%; p=0.40). Weight loss, gastric tube dependence at six months, acute renal injury and grade 3 or 4 hematological toxicity were all similar between both groups.
HPV-related SCCOPx treated with definitive CRT with either HDC or WC had similar toxicity profile. HDC had better EFS when compared with WC and this seems to be driven by increased distant failure rates, although the OS was similar.
比较大剂量顺铂（HDC）与每周顺铂（WC）在人乳头瘤病毒（HPV）相关口咽鳞状细胞癌（SCCOPx）患者根治性放化疗（CRT）中的疗效和毒性。
回顾性分析2010年至2014年在单一机构接受顺铂根治性CRT治疗的所有p16阳性SCCOPx患者。采用CTCAE v 4.03毒性标准。采用Kaplan-Meier法估计无事件生存期（EFS）和总生存期（OS）。
纳入的55例患者中，22例患者在第1天和第22天接受100mg/m剂量的HDC治疗；其余33例患者接受40mg/m的WC治疗。两组顺铂的中位总剂量均为200mg/m。中位随访31个月时，HDC组有1例局部复发，无远处转移。WC组共有6例复发（2例局部，4例远处）。与WC组相比，HDC组的2年EFS估计值更好（96%对75%；p=0.04）。2年OS无显著差异（95%对94%；p=0.40）。两组在体重减轻、6个月时胃管依赖、急性肾损伤和3级或4级血液学毒性方面均相似。
HPV相关的SCCOPx患者接受HDC或WC根治性CRT治疗时毒性特征相似。与WC相比，HDC的EFS更好，这似乎是由远处转移率增加所致，尽管OS相似。
