Weekly cisplatin with radiotherapy for locally advanced head and neck squamous cell carcinoma.

Background
Although commonly used for the treatment of locally advanced head and neck squamous cell carcinoma (HNSCC) concomitant radio-chemotherapy (RT-CT) with weekly cisplatin has not been definitely studied. We conducted a single centre retrospective study with the aim to evaluate efficacy and acute toxicity of definitive concomitant RT-CT with 40 mg/m² weekly cisplatin in patients with locally advanced HNSCC with a particular emphasis on radiotherapy modality (conventional or accelerated) and dose of cisplatin delivered.
Method
One hundred and twelve consecutive patients were included. They were given cisplatin 40 mg/m²/week concomitantly with conventionally fractionated (CFRT) (N = 33) or accelerated (ART) (N = 79) radiotherapy.
Results
Radiotherapy was delivered according to the treatment plan in 104 patients and full dose was given to 107 patients. A median cumulative cisplatin dose of 240 mg/m² was delivered to patients treated with CFRT and of 200 mg/m² to those treated with ART. Overall complete response rate was 81.3%. With a median follow up of 38.4 months, median overall survival was 75 months, not influenced by radiotherapy type or cisplatin dose received. The most clinically significant grade 3 or 4 acute toxicities were stomatitis (35.7%), neutropenia (25%), anemia (12.5%) and acute kidney injury (5.4%).
Conclusion
Our study shows that a median cumulative dose of 200 mg/m² cisplatin can be safely delivered using a weekly regimen to patients treated with concomitant radiotherapy (CFRT or ART). Efficacy results and toxicity compare favourably with those described with triweekly cisplatin RT-CT suggesting that a randomized comparison should be undertaken.