Toxicity and efficacy of accelerated radiotherapy with concurrent weekly cisplatin for locally advanced head and neck carcinoma.

Driessen, Chantal M L; Janssens, Geert O; van der Graaf, Winette T A; Takes, Robert P; Merkx, Thijs A W; Melchers, Willem J G; Kaanders, Hans A M; van Herpen, Carla M L · Head Neck · 2016

prospective_cohort · Level II

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Abstract

The purpose of this report was to present the results of accelerated radiotherapy (RT) with concomitant weekly cisplatin in head and neck cancer. One hundred six patients received concomitant cisplatin 40 mg/m(2) weekly with accelerated RT up to a dose of 68 Gy over 5.5 weeks. Ninety-nine percent of the patients received planned RT and 90% received ≥5 cycles of cisplatin. Moist desquamation of skin developed in 45% and confluent mucositis in 82%. Feeding tubes were required in 79% of the patients, and after 12 months in 4%. One patient developed nephrotoxicity. Three-year locoregional control, disease-free survival (DFS), and overall survival (OS) were 72%, 54%, and 61%, respectively. Human papillomavirus (HPV) status was positive on polymerase chain reaction (PCR) and p16 in 11 of 50 patients with oropharyngeal carcinoma. Three-year OS was 81% and 66% in HPV-positive versus HPV-negative patients with oropharyngeal carcinoma. Concomitant weekly cisplatin 40 mg/m(2) with accelerated RT was well tolerated and treatment compliance was high. © 2015 Wiley Periodicals, Inc. Head Neck 38: E559-E565, 2016.

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