Get access

Low-dose weekly platinum-based chemoradiation for advanced head and neck cancer

Authors

  • John M. Watkins MD,

    1. Department of Radiation Oncology, Medical University of South Carolina, Charleston, South Carolina, U.S.A.
    Search for more papers by this author
  • A. Jason Zauls MD,

    1. Department of Radiation Oncology, Medical University of South Carolina, Charleston, South Carolina, U.S.A.
    Search for more papers by this author
  • Amy H. Wahlquist MS,

    1. Department of Biostatistics, Bioinformatics, and Epidemiology, Medical University of South Carolina, Charleston, South Carolina, U.S.A.
    Search for more papers by this author
  • Keisuke Shirai MD,

    1. Department of Hematology and Oncology, Medical University of South Carolina, Charleston, South Carolina, U.S.A.
    Search for more papers by this author
  • Elizabeth Garrett-Mayer PhD,

    1. Department of Biostatistics, Bioinformatics, and Epidemiology, Medical University of South Carolina, Charleston, South Carolina, U.S.A.
    Search for more papers by this author
  • M. Boyd Gillespie MD,

    1. Department of Otolaryngology–Head and Neck Surgery, Medical University of South Carolina, Charleston, South Carolina, U.S.A.
    Search for more papers by this author
  • Terry A. Day MD,

    1. Department of Otolaryngology–Head and Neck Surgery, Medical University of South Carolina, Charleston, South Carolina, U.S.A.
    Search for more papers by this author
  • Anand K. Sharma MD

    Corresponding author
    1. Department of Radiation Oncology, Medical University of South Carolina, Charleston, South Carolina, U.S.A.
    • Medical University of South Carolina, Department of Radiation Oncology, 169 Ashley Avenue, Charleston, SC 29414
    Search for more papers by this author

  • Presented at the 7th International Conference on Head and Neck Cancer, San Francisco, California, U.S.A., July 19–23, 2008.

  • This work was supported with resources and the use of facilities at the Ralph H. Johnson Veterans' Affairs Medical Center, Charleston, South Carolina

Abstract

Objectives/Hypothesis:

The optimal concurrent chemoradiotherapy regimen for definitive treatment of locoregionally advanced head and neck cancer remains to be determined. The present investigation reports toxicities, disease control, patterns of failure, and survival outcomes in a large mature cohort of patients treated with low-dose weekly platinum-based concurrent chemoradiotherapy.

Study Design:

Retrospective single-institution series.

Methods:

Toxicity and outcome data for locoregionally advanced head and neck cancer patients treated with low-dose weekly platinum-based chemotherapy concurrent with standard fractionation radiotherapy were retrospectively collected and analyzed from a clinical database. Survival analysis methods, including Kaplan-Meier estimation and competing risks analysis, were used to assess locoregional disease control, freedom from failure, and overall survival.

Results:

Ninety-six patients were eligible for the present analysis. Nearly all patients had American Joint Committee on Cancer clinical stage III to IVB disease (99%). Severe acute toxicities included grade 3 mucositis (61%), grade 3/4 nausea (27%/1%), and grade 3 neutropenia (8%). Thirty-seven patients (38%) required hospitalization for a median of 7 days (range, 1–121). Ninety-two percent of patients completed the fully prescribed course of radiotherapy, and 87% completed ≥6 cycles of chemotherapy. At a median survivor follow-up of 40 months (range, 8–68), 47% of patients were without evidence of disease recurrence. The estimated 4-year freedom from failure and overall survival were 48% and 58%, respectively. Initial site(s) of disease failure were locoregional for 22 patients, locoregional and distant (five patients), and distant only (14 patients).

Conclusions:

Weekly low-dose platinum-based chemotherapy with full-dose daily radiotherapy is a tolerable alternative regimen for locoregionally advanced head and neck cancers, with comparable efficacy and patterns of failure to alternative regimens. Laryngoscope, 2010

Get access to the full text of this article

Ancillary