Shinohara Shogo, Takebayashi Shinji, Hamaguchi Kiyomi, Michida Tetsuhiko, Tobe Yota, Ikenaga Tadashi, Yasumoto Mami, Hamamoto Ayami, Imagumbai Toshiyuki, Mitsuyoshi Takamasa, Ashida Ryo, Iwai Takahiro, Okabayashi Shun
Department of Otolaryngology-Head and Neck Surgery, Kobe City Medical Center General Hospital, Kobe, Japan.
Department of Radiation Oncology, Kobe City Medical Center General Hospital, Kobe, Japan.
Clin Med Insights Oncol. 2021 Oct 4;15:11795549211048417. doi: 10.1177/11795549211048417. eCollection 2021.
Concurrent chemoradiotherapy (CCRT) with tri-weekly high-dose cisplatin (HDC) is considered the standard regimen. However, due to significant toxicity, various weekly low-dose schedules have been increasingly used. We investigated the tolerability and survival of patients with head and neck squamous cell carcinoma (HNSCC) who underwent CCRT with low-dose weekly cisplatin (LDC) for Japanese population.
A retrospective review was conducted among patients with HNSCC who were treated with CCRT/LDC in our institute. Ninety-five patients who met the criteria were enrolled in this study. We evaluated the cycle and cumulative cisplatin dose, completion rate of radiotherapy, adverse events, and survival outcome.
The mean cycles and cumulative cisplatin dose were 4.7 cycles and 187 mg/m. All patients completed planned dose of radiation without prolonged breaks. Leucopoenia was the most frequent dose-limiting factor and 44% patients developed grade 3 or 4 toxicity. The 2-year overall survival and recurrence-free survival were 93% and 74%, respectively. The significant differences of survival outcomes between the patients with total cisplatin dose (⩾200 mg and <200 mg) or among age distribution (35-55, 56-75, and ⩾76) were not observed.
Concurrent chemoradiotherapy/LDC can be safely administered with acceptable toxicity and survival outcome even if the patients with higher age, lower eGFR, and so on.
同步放化疗(CCRT)联合每三周一次的高剂量顺铂(HDC)被认为是标准方案。然而,由于显著的毒性,各种每周低剂量方案已越来越多地被使用。我们针对日本人群,研究了接受低剂量每周顺铂(LDC)同步放化疗的头颈部鳞状细胞癌(HNSCC)患者的耐受性和生存率。
对在我们研究所接受CCRT/LDC治疗的HNSCC患者进行回顾性研究。95名符合标准的患者纳入本研究。我们评估了顺铂的周期数和累积剂量、放疗完成率、不良事件和生存结果。
平均周期数和累积顺铂剂量分别为4.7个周期和187mg/m²。所有患者均完成了计划的放疗剂量,无长时间中断。白细胞减少是最常见的剂量限制因素,44%的患者出现3级或4级毒性。2年总生存率和无复发生存率分别为93%和74%。未观察到总顺铂剂量(⩾200mg和<200mg)患者之间或年龄分布(35 - 55岁、56 - 75岁和⩾76岁)之间生存结果的显著差异。
即使是年龄较大、估算肾小球滤过率较低等患者,同步放化疗/LDC也可安全给药,毒性和生存结果均可接受。