Concurrent chemoradiation with daily low dose cisplatin for advanced stage head and neck carcinoma

详细信息	查看全文 | 推荐本文 |

• 作者：Frank J.P. Hoebers ; Wilma Heemsbergen ; Alfons J.M. Balm ; Mathilde van Zanten ; Jan H. Schornagel ; Coen R.N. Rasch
• 关键词：Chemoradiation ; Cisplatin ; Radiotherapy ; Head and neck cancer
• 刊名：Radiotherapy and Oncology
• 出版年：2007
• 期刊代码：231_01678140
• 类别：med
• 出版时间：October 2007
• 卷：85
• 期：1
• 页码：42-47
• 文件大小：83 K

摘要

To evaluate treatment results of concurrent chemoradiation with daily low dose cisplatin.

Materials and methods

121 patients with advanced stage HNSCC were treated with RT (35 × 2 Gy) and cisplatin (6 mg/m² i.v. ×20, daily before RT). After 47 patients, the treatment protocol (Standard Group) was changed: Daily i.v. prehydration and accelerated RT were given to the subsequent 74 patients (Hydr-Ac-RT Group).

Results

Mean follow-up was 29 months (range 7–62). More chemotherapy could be administered in the Hydr-Ac-RT Group (maximum no. of 20 cisplatin-infusions increased from 59%to 91%of patients, p = 0.008), with less renal toxicity (p < 0.001) and less hospital admissions (p < 0.02). However, mucositis was more pronounced and tubefeeding more frequent in the Hydr-Ac-RT Group. The CR rate of the primary tumor increased from 74%(Standard Group) to 90%(Hydr-Ac-RT Group) (p = 0.06), although this did not lead to an improvement in loco-regional control.

Conclusions

Concurrent chemoradiation with daily low dose cisplatin is feasible and effective for selected patients with advanced HNSCC. Although the addition of accelerated RT resulted in more mucositis and tubefeeding, the introduction of prehydration led to better compliance to therapy with more chemotherapy administered and less hospital admissions.