A Meta-analysis of Weekly Cisplatin Versus Three Weekly Cisplatin Chemotherapy Plus Concurrent Radiotherapy (CRT) for Advanced Head and Neck Cancer (HNC)

Overview

Journal Oncotarget

Specialty Oncology

Date 2016 Sep 8

PMID 27602493

Citations 21

Authors

Jian Guan

Yue Zhang

Qinyang Li

Yaowei Zhang

Lu Li

Min Chen

Nanjie Xiao

Longhua Chen

Affiliations

Soon will be listed here.

Abstract

Purpose: This study was performed to compare the efficacies and acute toxicities in weekly- and three weekly- cisplatin based concurrent chemoradiotherapy (CCRT) for advanced HNC patients.

Results: 779 patients of 10 studies were eligible. No difference in the 2-, 3-year OS or 1-, 2-year LRFS was observed, whereas patients in three weekly CCRT arm tended to have a better 5-year OS (HR=1.79, 95%C 0.97-3.31, p=0.06). Weekly arm seemed to show less gastrointestinal toxicities (RR=0.59, 95%CI 0.34-1.02, p=0.06), but similar hematologic toxicity compared to three weekly arm. Subgroup analysis displayed more grade ≥3 mucositis (RR=1.72, p=0.01), and more chemotherapy related delay/interrupt (RR=2.68, p<0.0001) in weekly arm for non-nasopharynx carcinoma (non-NPC) HNC.

Methods: We conducted the meta-analysis by searching PubMed, MEDLINE, ScienceDirect, Cochrane Library and China National Knowledge Infrastructure (CNKI) databases. The primary endpoint was overall survival (OS) with secondary endpoints locoregional recurrence-free survival (LRFS) and grade≥3 acute adverse events. RevMan 5.2 was used to perform statistical analyses.

Conclusions: Three weekly cisplatin-based CCRT might achieve a higher long-term OS with no significant difference in a shorter OS and LRFS. Weekly arm was associated with less gastrointestinal toxicities but more grade≥3 mucositis and chemotherapy related delay/interrupt. Large randomized trials were urgent to further define superiority of these two regimens.

Citing Articles

Comparison of the Effect of Weekly Cisplatin Versus Three Weekly Cisplatin in Concurrent Chemoradiotherapy of Head and Neck Cancer: A Pilot Study.

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A prospective randomized study comparing the efficacy between povidone-iodine gargling and benzydamine hydrochloride for mucositis prevention in head and neck cancer patients receiving concurrent chemoradiotherapy.

Kannarunimit D, Chotirut A, Prayongrat A, Pakvisal N, Sitthideatphaiboon P, Lertbutsayanukul C Heliyon. 2023; 9(4):e15437.

PMID: 37151677 PMC: 10161604. DOI: 10.1016/j.heliyon.2023.e15437.

A Prospective Randomised Comparative Study Between Weekly Cisplatin Versus Three Weekly Cisplatin with Radiotherapy in Unresectable Locally Advanced Head and Neck Cancer.

Panihar C, Rawat S, Singotia L, Raj A, Jain R Indian J Otolaryngol Head Neck Surg. 2022; 74(Suppl 2):2670-2675.

PMID: 36452529 PMC: 9702380. DOI: 10.1007/s12070-020-02350-6.

Free three-dimensional image software in local extension assessment of oral squamous cell carcinoma: a pilot study.

Gomes J, Costa A, Chone C, Altemani A, Altemani J, Lima C Braz J Otorhinolaryngol. 2022; 88 Suppl 4:S117-S123.

PMID: 36030174 PMC: 9756073. DOI: 10.1016/j.bjorl.2022.07.001.

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