The Toxicity and Preliminary Clinical Outcomes of Low-Dose Weekly Cisplatin-Based Concurrent Chemoradiotherapy

Korean Journal of Head & Neck Oncology 2011;27(1):47-53.
Published online May 30, 2011.

Tae-Yong Kim;Kyoung Ju Kim;Ki Hwan Kim;Ji Eun Kim;Sun-Won Park;So Won Oh;Young Ho Jung

두경부암에서 저용량 Cisplatin 기반 매주 요법의 항암방사선 동시치료의 독성과 예비 임상 결과

김태용;김경주;김기환;김지은;박선원;오소원;정영호

Abstract

Purpose
：Concurrent chemoradiotherapy(CCRT) with 3 weekly cisplatin is the standard treatment of lo-cally advanced head and neck cancer(HNC). The aim is to evaluate the efficacy and toxicities of low-dose week-ly cisplatin-based CCRT, which was devised to reduce the toxicity of CCRT. Method：We retrospectively ana-lyzed HNC patients who received low-dose weekly cisplatin-based CCRT between 2008 and 2010. Cisplatin 35mg/m 2 was weekly given to all patients during radiotherapy. The efficacy was evaluated by the degree of clinical response, treatment failure and survival. The toxicity was evaluated by hematologic toxicities and oral mucositis. Results：A total of 27 patients were analyzed and median age was 59(range 31-81). The ratio of administered dose of radiotherapy and cisplatin to planned dose were 0.98 and 0.93, respectively. Complete re-mission and partial remission were 73% and 23%, respectively. Treatment failure was observed in 8(30%) pa-tients. 1-year survival rate and 1-year disease free survival rate were 82% and 59%, respectively. Overall surviv-al and progression-free survival did not reach median time. Grade 3/4 anemia, neutropenia, thrombocytopenia and oral mucositis were observed in 11%, 19%, 7% and 32% of patients, respectively. In terms of administered cycles, however, only 1-3% of grade 3/4 hematologic toxicities occurred among total 190 cycles. Severe oral mucositis were statistically associated with old age(p=0.003). Treatment failure had no statistical relation with age, pathology, primary site and stage. Conclusion：Low-dose weekly cisplatin-based CCRT seemed to deliv-er enough dose of cisplatin and to show low drop-out rate and good efficacy with low hematologic toxicities.

Key Words: Head and neck cancer, Toxicity, Chemoradiotherapy