Patients with locally advanced NPC (stage II–IVb) were randomly assigned to a regimen of either seven doses of cisplatin (40 mg/m2) given once a week or three doses of cisplatin (100 mg/m2) given every 3 weeks concurrently during RT.
Of 109 eligible patients, 53 were assigned to the weekly regimen and 56 to the triweekly regimen. The two groups were comparable with respect to demographic and clinical characteristics. There were no significant differences in mean RT dose (68.3 Gy vs. 67.3 Gy, p = 0.559) and mean cisplatin dose (248.9 mg/m2vs. 256.6 mg/m2, p = 0.433) between the two regimens. The primary endpoint was 3-year progression-free survival, which was not different between the regimens (64.9% vs. 63.8%, p = 0.074). Overall, the occurrence of grade 3–4 toxicities was similar between the two arms (47.2% vs. 39.3%, p = 0.443). Quality of life (QoL) related to functional outcomes 3 weeks after treatment completion was better for the weekly regimen.
Although no definitive conclusions can be made, a once-weekly cisplatin regimen appears to be associated with improved QoL and is not inferior to the standard triweekly regimen with respect to efficacy and toxicity profiles.