Journal of Personalized Medicine (Jun 2023)

First Results of Concurrent Chemoradiation with Two Courses of 5 × 25 mg/m<sup>2</sup> Cisplatin for Locally Advanced Head and Neck Cancer

  • Inga Zwaan,
  • Tamer Soror,
  • Christian Idel,
  • Ralph Pries,
  • Karl L. Bruchhage,
  • Samer G. Hakim,
  • Nathan Y. Yu,
  • Dirk Rades

DOI
https://doi.org/10.3390/jpm13061006
Journal volume & issue
Vol. 13, no. 6
p. 1006

Abstract

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Many patients with squamous cell carcinoma of the head and neck (SCCHN) receive cisplatin-based chemoradiation. Cisplatin 100 mg/m2 every three weeks is toxic and alternative cisplatin regimens are desired. Two courses of 20 mg/m2/day 1–5 (cumulative 200 mg/m2) were shown to be similarly effective and better tolerated than 100 mg/m2 every three weeks. Previous studies suggested that cumulative doses >200 mg/m2 may further improve outcomes. In this study, 10 patients (group A) receiving two courses of 25 mg/m2/day 1–5 (cumulative 250 mg/m2) in 2022 were retrospectively matched and compared to 98 patients (group B) receiving two courses of 20 mg/m2/day 1–5 or 25 mg/m2/day 1–4 (cumulative 200 mg/m2). Follow-up was limited to 12 months to avoid bias. Group A achieved non-significantly better 12-month loco-regional control (100% vs. 83%, p = 0.27) and metastases-free survival (100% vs. 88%, p = 0.38), and similar overall survival (89% vs. 88%, p = 0.90). No significant differences were found regarding toxicities, completion of chemotherapy, and interruption of radiotherapy. Given the limitations of this study, chemoradiation with two courses of 25 mg/m2/day 1–5 appears an option for carefully selected patients as a personalized treatment approach. Longer follow-up and a larger sample size are needed to properly define its role.

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