Department of Medical Oncology, Karmanos Cancer Institute, Wayne State University, Detroit, Michigan.
Department of Medicine, Emory University, Atlanta, Georgia.
Head Neck. 2019 May;41(5):1490-1498. doi: 10.1002/hed.25379. Epub 2019 Mar 5.
Cisplatin-based chemoradiotherapy is standard of care for locally advanced squamous cell carcinoma of the head and neck. This systemic review compared efficacy and safety of weekly vs triweekly cisplatin in locally advanced squamous cell carcinoma of the head and neck.
Among 1500 prospective studies published from 1970 to 2015, 39 (18 weekly, 21 triweekly) including 3668 patients qualified for inclusion. Clinical outcomes were analyzed using weighted estimates and 2-tailed t test for comparisons; significance level was 0.05.
Locoregional control was 58% (CI 53%-63%) vs 61% (CI 56%-65%; P = .7). The 2-year overall survival (OS) was 74% (CI 66%-80%) for weekly vs 67% (64%-69%) triweekly groups (P = .67). The 2-year progression-free survival (PFS) was 69% (CI 59%-77%) for weekly vs 62% (CI 58%-65%) triweekly groups (P = .9). Grade 3 to 5 toxicities were 36% vs 40% (P = .37) in weekly vs triweekly groups.
Weekly cisplatin was comparable in efficacy and safety to the triweekly regimen. Our analysis supports the use of weekly or triweekly cisplatin in locally advanced squamous cell carcinoma of the head and neck, with tolerability being a key factor in selection.
顺铂为基础的放化疗是局部晚期头颈部鳞状细胞癌的标准治疗方法。本系统综述比较了局部晚期头颈部鳞状细胞癌中每周与每三周给予顺铂的疗效和安全性。
在 1970 年至 2015 年发表的 1500 项前瞻性研究中，有 39 项（18 项每周，21 项每三周），包括 3668 例患者符合纳入标准。使用加权估计和双侧 t 检验分析临床结局；显著性水平为 0.05。
局部区域控制率为 58%（CI 53%-63%）与 61%（CI 56%-65%；P=0.7）。每周组和每三周组的 2 年总生存率（OS）分别为 74%（CI 66%-80%）和 67%（64%-69%）（P=0.67）。每周组和每三周组的 2 年无进展生存率（PFS）分别为 69%（CI 59%-77%）和 62%（CI 58%-65%）（P=0.9）。每周组和每三周组的 3 级至 5 级毒性发生率分别为 36%和 40%（P=0.37）。
每周给予顺铂在疗效和安全性方面与每三周方案相当。我们的分析支持在局部晚期头颈部鳞状细胞癌中使用每周或每三周给予顺铂，耐受性是选择方案的关键因素。
