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    Dose intensity comparison between weekly and 3-weekly Cisplatin delivered concurrently with radical radiotherapy for head and neck cancer: a retrospective comparison from New Cross Hospital, Wolverhampton, UK.

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    Authors
    Ho, Kean F
    Swindell, Ric
    Brammer, Caroline V
    Affiliation
    Deansley Centre, New Cross Hospital, Wolverhampton, UK. kean.ho@manchester.ac.uk
    Issue Date
    2008
    
    Metadata
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    Abstract
    AIMS: In this retrospective comparison, we describe the differences in dose intensity, delays and toxicity between weekly Cisplatin and 3-weekly Cisplatin given concurrently to patients with locally advanced squamous head and neck cancer (SCCHN) at New Cross Hospital, Wolverhampton. MATERIALS AND METHODS: Fifty-one patients received radical Cisplatin based chemoradiotherapy for stage 4a SCCHN of the head and neck between September 2000 and December 2004. Twenty-seven patients were treated with 3-weekly inpatient Cisplatin for 3 cycles (20 patients-80 mg/m(2); 7 patients-100 mg/m(2)) concomitantly with radiotherapy (66-70 Gy/33-35 fractions). Twenty-four patients received a similar radiotherapy schedule but received weekly Cisplatin 33-40 mg/m(2). RESULTS: More patients received a higher cumulative dose of at least 240 mg/m(2) if given weekly Cisplatin 40 mg/m(2) or 3-weekly Cisplatin 80 mg/m(2) compared with those receiving Cisplatin 3-weekly 100 mg/m(2) (p=0.04). Maximum cumulative dose achievable in the latter group was only 200 mg/m(2) and none achieved the full 3 cycles. Mean Cisplatin dose in the weekly Cisplatin 40 mg/m(2) regime (mean 202 mg/m(2)) and 3-weekly arm of 80 mg/m(2) (mean 203 mg/m(2)) was higher than that reached if given 3-weekly Cisplatin 100 mg/m(2) (mean 180 mg/m(2)) although statistically insignificant (p=0.39) due to the small number of patients. More delays (29% vs. 41%) and omission of chemotherapy (5.6% vs. 17.4%) occurred in the 3-weekly compared with the weekly regime. Toxicity, radiotherapy overall treatment time and delays were similar between the two groups. CONCLUSION: Delivery of 100 mg/m(2) Cisplatin 3-weekly with radiotherapy was less tolerated than 40 mg/m(2) weekly and resulted in less patients achieving cumulative dose beyond 200 mg/m(2), potentially lowering chemotherapy dose intensity.
    Citation
    Dose intensity comparison between weekly and 3-weekly Cisplatin delivered concurrently with radical radiotherapy for head and neck cancer: a retrospective comparison from New Cross Hospital, Wolverhampton, UK. 2008, 47 (8):1513-8 Acta Oncol
    Journal
    Acta Oncologica
    URI
    http://hdl.handle.net/10541/68838
    DOI
    10.1080/02841860701846160
    PubMed ID
    18607863
    Type
    Article
    Language
    en
    ISSN
    1651-226X
    ae974a485f413a2113503eed53cd6c53
    10.1080/02841860701846160
    Scopus Count
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