Tanaka Akihisa, Nishimura Ari, Mikami Shinji, Kimura Takahiro, Yamaki Kaori, Isohashi Fumiaki, Uemura Hirokazu, Kitahara Tadashi
Department of Otolaryngology-Head and Neck Surgery, Nara Medical University, 840 Shijo-cho, Kashihara, Nara 634-8522, Japan.
Department of Otolaryngology-Head and Neck Surgery, Nara Medical University, 840 Shijo-cho, Kashihara, Nara 634-8522, Japan.
Auris Nasus Larynx. 2025 Aug;52(4):296-301. doi: 10.1016/j.anl.2025.04.012. Epub 2025 May 2.
Low-dose weekly cisplatin with concurrent radiotherapy (wCRT) is considered a potential alternative to the current standard of high-dose three-weekly cisplatin with concurrent RT (twCRT) for the treatment of locally advanced head and neck squamous cell carcinoma (LA-HNSCC) owing to its reduced toxicity. This study aimed to investigate the efficacy and safety of wCRT for LA-HNSCC treatment.
This retrospective analysis included patients with stage III or IV LA-HNSCC who underwent definitive wCRT as the first-line treatment between January 2007 and December 2021. Patients with distant metastases or p16-positive oropharyngeal cancer or who had undergone induction chemotherapy were excluded.
Seventy-eight eligible patients were identified, 32 of whom were aged ≥70 years. The 2- and 5-year overall survival (OS) rates were 81.0% and 63.5%, respectively, with a complete response rate of 89.7%. A cumulative cisplatin dose of ≥200 mg/m² was administered to 88.5% of the patients and found to be a significant prognostic factor for OS in both univariate and multivariate analyses. Acute adverse events were generally manageable, with fewer non-haematological toxicities, likely owing to multidisciplinary supportive care.
Although twCRT remains the standard, wCRT appears a viable and less toxic alternative for treating LA-HNSCC.
