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Compliance, toxicity and efficacy in weekly versus 3-weekly cisplatin concurrent chemoradiation in locally advanced head and neck cancer

Published online by Cambridge University Press:  04 September 2018

Sandeep Muzumder Open the ORCID record for Sandeep Muzumder [Opens in a new window] ,
Nirmala Srikantia ,
Ganesha Dev Vashishta ,
Avinash H. Udayashankar ,
John Michael Raj ,
M. G. John Sebastian  and
Prashanth Bhat Kainthaje
Sandeep Muzumder*
Affiliation:
Department of Radiation Oncology, St. John’s Medical College and Hospital, Bengaluru, Karnataka, India
Nirmala Srikantia
Affiliation:
Department of Radiation Oncology, St. John’s Medical College and Hospital, Bengaluru, Karnataka, India
Ganesha Dev Vashishta
Affiliation:
St. John’s Medical College and Hospital, Bengaluru, Karnataka, India
Avinash H. Udayashankar
Affiliation:
Department of Radiation Oncology, St. John’s Medical College and Hospital, Bengaluru, Karnataka, India
John Michael Raj
Affiliation:
Department of Biostatistics, St John’s Medical College, Bengaluru, Karnataka, India
M. G. John Sebastian
Affiliation:
Department of Radiation Oncology, St. John’s Medical College and Hospital, Bengaluru, Karnataka, India
Prashanth Bhat Kainthaje
Affiliation:
Department of Radiation Oncology, St. John’s Medical College and Hospital, Bengaluru, Karnataka, India
*
Author for correspondence: Dr Sandeep Muzumder, Department of Radiation Oncology, St. John’s Medical College and Hospital, Sarjapur Road, Bengaluru, Karnataka 560034, India. Tel: +91 974 215 7090. E-mail: sandeepmuzumder@gmail.com
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Abstract

Aim

Weekly low-dose cisplatin is routinely used in concurrent chemoradiation (CCRT) in locally advanced head and neck cancer (LAHNC), despite 3-weekly cisplatin being the standard of care. We compared compliance, toxicity and efficacy in weekly versus 3-weekly cisplatin CCRT in LAHNC.

Materials and methods

In this retrospective study, weekly cisplatin 50 mg flat dose was compared with 3-weekly cisplatin 100 mg/m2, when given in CCRT in LAHNC with curative intent. The study outcome was compliance, toxicity, loco-regional control (LRC), disease-free survival (DFS) and overall survival (OS).

Results

Eighty-four patients received CCRT from January 2013 to June 2017, 40 in weekly and 44 in 3-weekly arm. There was no difference between the arms not completing scheduled radiation therapy or chemotherapy. Patient receiving 200 mg/m2 cisplatin is higher in 3-weekly arm compared with weekly arm (75 versus 40·9%; p<0·0015). Compared with 3-weekly arm, more patient in weekly arm developed grade ≥3 mucositis (52·5 versus 15·9%, p=0·0004), day care intravenous hydration (82·5 versus 38·6% <0·0001) and in-patient admission (55·0 versus 18·2%; p=0·0004). The 2-year LRC, DFS and OS in weekly versus 3-weekly arm were: 70 versus 61·4% (p=0·406); 67·5 versus 56·8% (p=0·314); 67·5 versus 61·4% (p=0·558), respectively. The median time to LRR, DFs and OS was not reached.

Conclusions

Weekly cisplatin is comparable with 3-weekly cisplatin in terms of compliance, disease control and survival, but with increased grade 3 mucositis and higher admissions for supportive care.

Keywords

3-weekly chemotherapycisplatinconcurrent chemoradiationhead and neck cancerweekly chemotherapy
Type
Original Article
Information
Journal of Radiotherapy in Practice , Volume 18 , Issue 1 , March 2019 , pp. 21 - 25
Copyright
© Cambridge University Press 2018 

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Footnotes

Cite this article: Muzumder S, Srikantia N, Vashishta GD, Udayashankar AH, Raj JM, Sebastian MGJ, Kainthaje PB. (2019) Compliance, toxicity and efficacy in weekly versus 3-weekly cisplatin concurrent chemoradiation in locally advanced head and neck cancer. Journal of Radiotherapy in Practice18: 21–25. doi: 10.1017/S1460396918000341

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