Startseite Kongressberichte 2017 ESMO 2017 Congress Head & Neck Cancer Highlights 1065P - 3-weekly or weekly cisplatin concurrently with radiotherapy for patients with locally advanced squamous cell carcinoma of the head and neck: A multicentre, retrospective analysis

1065P - 3-weekly or weekly cisplatin concurrently with radiotherapy for patients with locally advanced squamous cell carcinoma of the head and neck: A multicentre, retrospective analysis

Background

Concurrent chemoradiotherapy with cisplatin is standard for patients (pts) with loco-regionally advanced squamous cell carcinoma of the head and neck (LA-SCCHN). The standard regimen includes 3-weekly cisplatin, but weekly regimens are often used to lower toxicity. Reaching a cumulative dose of > 200 mg/m2 cisplatin was shown being associated with improved outcome. We herein investigated cumulative dose reached and toxicity between the both widely used 3-weekly and weekly cisplatin regimens with concurrent radiotherapy.

Methods

Multicentre, retrospective analysis of all patients with LA-SCCHN treated at 3 centers in Switzerland between 06/2008 and 12/2015. We used descriptive statistics and logistic regression (uni- and multivariable) to investigate the association between the chosen cisplatin regimen (weekly versus 3-weekly) and the chance to reach the cumulative cisplatin dose of > 200 mg/m2. Landmark approach (8 weeks after start of treatment) was applied for investigating the prognostic impact of the cumulative cisplatin dose on survival using Cox regression techniques.

Results

We included 314 eligible pts (3-weekly schedule, N = 127; weekly schedule, N = 187). Median cumulative cisplatin dose was 200 mg/m2 (IQR 150-300) for pts treated with a 3-weekly schedule and 160 mg/m2 (120-240) for the weekly schedule, consequently more pts treated with a 3-weekly schedule reached a cumulative dose >200 mg/m2 (75.6% vs. 47.1%, p < 0.001). This association was also observed in multivariable analysis adjusted for age and sex (OR 3.46, 95% confidence interval [CI], 2.1 - 5.7). The 3-weekly regimen led to a higher rate of renal toxicity (33.1% vs. 20.9%, p = 0.022), but not ototoxicity (15% vs. 12.8%). In the landmark analysis, we could not confirm that a cisplatin dose >200 mg/m2 is associated with better survival (HR 1.3, 95% CI 0.8 -1.9).

Conclusions

Significantly more patients receive a cumulative of dose of > 200 mg/m2, when treated with a 3-weekly schedule compared to weekly dosing. This comes at the cost of more renal toxicity. Due to the non-randomized nature of this analysis, no conclusions on the efficacy of the respective schedules should be drawn.

Clinical trial identification

Not applicable.

Legal entity responsible for the study

University Hospital Basel

Funding

None

Disclosure

All authors have declared no conflicts of interest.