Asian Pacific Journal of Cancer Prevention

Asian Pacific Journal of Cancer Prevention (아시아태평양암예방학회)
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Weekly Cisplatin-Based Concurrent Chemoradiotherapy for Treatment of Locally Advanced Head and Neck Cancer: a Single Institution Study

  • Published : 2015.11.04
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Abstract

Background: The organ preservation approach of choice for the treatment of locally advanced head and neck cancers is concurrent chemoradiation with three weekly high doses of cisplatin. Although this is an efficacious treatment policy, it has high acute systemic and mucosal toxicities, which lead to frequent treatment breaks and increased overall treatment time. Hence, the current study was undertaken to evaluate the efficacy of concurrent chemoradiation using 40 mg/m2 weekly cisplatin. Materials and Methods: This is a single institutional retrospective study including the data of 266 locally advanced head and neck cancer patients who were treated with concurrent chemoradiation using 40 mg/m2 weekly cisplatin from January 2012 to January 2014. A p-value of < 0.05 was taken to be significant statistically for all purposes in the study. Results: The mean age of the study patients was 48.8 years. Some 36.1% of the patients had oral cavity primary tumors. The mean overall treatment time was 57.2 days. With a mean follow up of 15.2 months for all study patients and 17.5 months for survivors, 3 year local control, locoregional control and disease free survival were seen in 62.8%, 42.8% and 42.1% of the study patients. Primary tumor site, nodal stage of disease, AJCC stage of the disease and number of cycles of weekly cisplatin demonstrated statistically significant correlations with 3 year local control, locoregional control and disease free survival. Conclusions: Concurrent chemoradiotherapy with moderate dose weekly cisplatin is an efficacious treatment regime for locally advanced head and neck cancers with tolerable toxicity which can be used in developing countries with limited resources.

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References

  1. Adelstein DJ, Li Y, Adams GL, et al (2003). An Intergroup phase III comparison of standard radiation therapy and two schedules of concurrent chemo-radiotherapy in patients with unresectable squamous cell head and neck cancer. J Clin Oncol, 21, 92-8. https://doi.org/10.1200/JCO.2003.01.008
  2. Baykara M, Buyukberber S, Ozturk B, Coskun U, Unsal DK, Demirci U, et al (2013). Efficacy and safety of concomitant chemoradiotherapy with cisplatin and docetaxel in patients with locally advanced squamous cell head and neck cancers. Asian Pac J Cancer Prev, 14, 2557-61. https://doi.org/10.7314/APJCP.2013.14.4.2557
  3. Browman GP, Hodson DI, Mackenzie RG, Bestic N, Zuraw L (2001). Cancer care ontario practice guideline initiative head and neck cancer disease site group: choosing a concomitant chemotherapy and radiotherapy regimen for squamous cell head and neck cancer: A systematic review of the published literature with subgroup analysis. Head Neck, 23, 579-89. https://doi.org/10.1002/hed.1081
  4. Brizel DM, Esclamado R (2006). Concurrent chemoradiotherapy for locally advanced, nonmetastatic, squamous carcinoma of the head and neck: consensus, controversy, and conundrum. J Clin Oncol, 24, 2612-17. https://doi.org/10.1200/JCO.2005.05.2829
  5. Chaturvedi P, (2009). Head and neck surgery. J Can Res Ther, 5, 143.
  6. Cox JD, Stetz J, Pajak TF (1995). Toxicity criteria of the radiation therapy oncology group (RTOG) and the European organization for research and treatment of cancer (EORTC). Int J Radiat Oncol Biol Phys, 31, 1341-6. https://doi.org/10.1016/0360-3016(95)00060-C
  7. Dimri K, Pandey AK, Trehan R, Rai B, Kumar A (2013). Conventional radiotherapy with concurrent weekly cisplatin in locally advanced head and neck cancers of squamous cell origin - a single institution experience. Asian Pac J Cancer Prev, 14, 6883-88. https://doi.org/10.7314/APJCP.2013.14.11.6883
  8. Fan KY, Gogineni H, Zaboli D, et al (2012). Comparison of acute toxicities in two primary chemoradiation regimens in the treatment of advanced head and neck squamous cell carcinoma. Ann Surg Oncol, 19, 1980-7. https://doi.org/10.1245/s10434-012-2219-4
  9. Forastiere AA, Goepfert H, Maor M, et al (2003). Concurrent chemotherapy and radiotherapy for organ preservation in advanced laryngeal cancer. N Engl J Med, 349, 2091-98. https://doi.org/10.1056/NEJMoa031317
  10. Geeta SN, Padmanabhan TK, Samuel J, et al (2006). Comparison of acute toxicities of two chemotherapy schedules for head and neck cancers. J Cancer Res Ther, 2, 100-4. https://doi.org/10.4103/0973-1482.27584
  11. Gupta T, Agarwal JP, Ghosh-Laskar S, Parikh PM, D’Cruz AK, Dinshaw KA (2009). Radical radiotherapy with concurrent weekly cisplatin in loco-regionally advanced squamous cell carcinoma of the head and neck: a single-institution experience. Head Neck Oncol, 1, 17. https://doi.org/10.1186/1758-3284-1-17
  12. Lasrado S, Moras K, Pinto GJO, Bhat M, Hegde S, Sathian B, et al. (2014). Role of concomitant chemoradiation in locally advanced head and neck cancers. Asian Pac J Cancer Prev, 15, 4147-52. https://doi.org/10.7314/APJCP.2014.15.10.4147
  13. Marcu L, van Doorn T, Olver I (2003). Cisplatin and radiotherapy in the treatment of locally advanced head and neck cancer. Acta Oncol, 42, 315-25. https://doi.org/10.1080/02841860310004364
  14. Mishra A, Meherotra R, (2014). Head and neck cancer: Global burden and regional trends in India. Asian Pac J Cancer Prev, 15, 537-50. https://doi.org/10.7314/APJCP.2014.15.2.537
  15. Pandey KC, Revannasiddaiah S, Pant NK, Bhatt HC (2014). Stage-wise presentation of non-metastatic head and neck cancer: an analysis of patients from the Kumaon hills of India. Asian Pac J Cancer Prev, 15, 4957-61. https://doi.org/10.7314/APJCP.2014.15.12.4957
  16. Pignon JP, Bourhis J, Domenge C, Designe L (2000). Chemotherapy added to locoregional treatment for head and neck squamous cell carcinoma: three meta-analyses of updated individual data. Lancet, 355, 949-55. https://doi.org/10.1016/S0140-6736(00)90011-4
  17. Pignon JP, Baujat B, Bourhis J (2005). Individual patient data meta-analysesin head and neck carcinoma: What have we learnt? Cancer Radiother, 9, 31-6. https://doi.org/10.1016/j.canrad.2004.11.002
  18. Pignon JP, Maitre AL, Bourhis J (2007). Meta-analyses of chemotherapy in head and neck cancer (MACH-NC): An update. Int J Radiat Oncol Biol Phys, 69, 112-4.
  19. Pignon JP, le Maître A, Maillard E, Bourhis J; MACH-NC Collaborative Group (2009). Meta-analysis of chemotherapy in head and neck cancer (MACH-NC): an update on 93 randomised trials and 17,346 patients. Radiother Oncol, 92, 4-14. https://doi.org/10.1016/j.radonc.2009.04.014

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