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Postoperative reduced dose of cisplatin concomitant with radiation therapy in high- risk head and neck squamous cell carcinoma†
Article first published online: 11 MAR 2009
Copyright © 2009 American Cancer Society
Volume 115, Issue 11, pages 2464–2471, 1 June 2009
How to Cite
Franchin, G., Minatel, E., Politi, D., Gobitti, C., Talamini, R., Vaccher, E., Savignano, M. G., Trovo, M., Sulfaro, S. and Barzan, L. (2009), Postoperative reduced dose of cisplatin concomitant with radiation therapy in high- risk head and neck squamous cell carcinoma. Cancer, 115: 2464–2471. doi: 10.1002/cncr.24252
We have complied with all institutional and international ethical standards in the treatment of participants in this study.
- Issue published online: 20 MAY 2009
- Article first published online: 11 MAR 2009
- Manuscript Accepted: 5 NOV 2008
- Manuscript Revised: 30 OCT 2008
- Manuscript Received: 25 AUG 2008
- head and neck neoplasms;
- postoperative radiotherapy;
- low-dose concomitant cisplatin;
- squamous cell carcinoma
The role of low doses of cisplatin and concomitant postoperative radiotherapy in high risk head and neck squamous cell carcinoma has not yet been defined.
Patients treated with definitive surgery, who had histological evidence of involvement of more than 2 lymph nodes, extracapsular extension of disease, perineural and/or intravascular invasion, involved or close surgical margins, received postoperative radiotherapy plus 75 mg/m2 of cisplatin every 3 weeks during the radiotherapy cycle. The primary endpoints were to evaluate treatment compliance and overall, cause-specific, and disease-free survival.
A total of 142 patients were enrolled. With a median follow-up of 40 months, 5-year overall survival was 68%, cause-specific survival 78% and disease-free survival 82%. At multivariate analysis surgical margins status and extracapsular lymph node invasion were the only statistically significant prognostic factors. Fifty-three percent of the patients developed severe mucositis and 14% hematologic toxicity of grade 3. The 3 planned concomitant chemotherapy cycles were delivered to 48% of the patients.
Postoperative radiotherapy and concomitant low-dose cisplatin was an effective treatment in high risk head and neck patients. The total toxicity observed was lower compared with that reported with higher doses of cisplatin, although the delivery of all the 3 planned chemotherapy cycles was challenging. The distant failure rate was high, which was an unsatisfactory result. Cancer 2009. © 2009 American Cancer Society.