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

Overview

Journal Indian J Otolaryngol Head Neck Surg

Publisher Springer

Date 2022 Dec 1

PMID 36452529

Authors

Chinkal Panihar

Shyamji Rawat

Laxmi Singotia

Aishwarya Raj

Rajesh K Jain

Affiliations

Soon will be listed here.

Abstract

To compare the efficacy, compliance and the complications of weekly cisplatin 40 mg/m2 against the three weekly cisplatin 100 mg/m2 with EBRT(external beam radiotherapy) in unresectable locally advanced head and neck squamous cell carcinoma(LAHNSCC) Study design was Prospective randomized and comparative.85 Patients with histologically proven stage III-IVA LAHNSCC presenting from December 2017 to May 2019 were assigned to concurrent three weekly cisplatin 100 mg/m2 (arm 1) and weekly cisplatin 40 mg/m2 (arm 2) with EBRT. There were 41 patients were in arm 1 and 44 patients in arm 2. Statistical analysis was done using SPSS version 2.0. At 4 week of completion of treatment, response was assessed using RECIST(1.1) criteria.In Arm 1,61% patients and in arm 2 55% patients achieved complete response but the difference was statistically non- significant ( = 0.756).Median follow up was 12 months after which 49% patients in arm 1 and 38% in arm 2 had complete response whereas 12% patients in arm 1 and 15.5% patients in arm 2 had locoregional relapse. There was no statistically significant difference between the two arms in terms of mucositis, nausea,vomiting, dysphagia, acute skin reaction and ototoxicity. Leukopenia ( = 0.003),thrombocytopenia ( = 0.04) and acute renal toxicity ( = 0.004) was significantly more in three weekly arm. As compared to three weekly cisplatin, weekly cisplatin with radiotherapy is an acceptable approach in a limited resource setting due to good patient compliance where a large number of patients are treated on outpatient basis.

References

Rades D, Seidl D, Janssen S, Bajrovic A, Karner K, Strojan P . Comparison of weekly administration of cisplatin versus three courses of cisplatin 100 mg/m(2) for definitive radiochemotherapy of locally advanced head-and-neck cancers. BMC Cancer. 2016; 16:437. PMC: 4938984. DOI: 10.1186/s12885-016-2478-8. View

Nanda R, Katke A, Suneetha N, Thejaswini B, Pasha T, Jagannath K . A prospective randomized study comparing concurrent chemoradiation with weekly and 3 weekly cisplatin in locally advanced oropharyngeal carcinoma. South Asian J Cancer. 2019; 8(3):178-182. PMC: 6699241. DOI: 10.4103/sajc.sajc_270_18. View

Rawat S, Jain R, Verma C . Cetuximab Concurrent with Radiotherapy in Unresectable, Locally Advanced Squamous Cell Carcinoma of Head and Neck: Real-World Evidence from a Tertiary Care Hospital. Indian J Otolaryngol Head Neck Surg. 2022; 74(Suppl 2):1857-1863. PMC: 9702132. DOI: 10.1007/s12070-020-01877-y. View

MARCIAL V, Pajak T, Mohiuddin M, Cooper J, Al Sarraf M, Mowry P . Concomitant cisplatin chemotherapy and radiotherapy in advanced mucosal squamous cell carcinoma of the head and neck. Long-term results of the Radiation Therapy Oncology Group study 81-17. Cancer. 1990; 66(9):1861-8. DOI: 10.1002/1097-0142(19901101)66:9<1861::aid-cncr2820660902>3.0.co;2-i. View

Tripathi A, Rawat S . Comparative Study of Neoadjuvant Chemotherapy Followed by Definitive Chemoradiotherapy Versus Definitive Chemoradiotherapy Alone in Locally Advanced Carcinoma of Cervix. J Obstet Gynaecol India. 2019; 69(6):546-552. PMC: 6889094. DOI: 10.1007/s13224-019-01236-0. View

Negi P, Kingsley P, Srivastava H, Sharma S . Three Weekly Versus Weekly Cisplatin as Radiosensitizer in Head and Neck Cancer: a Decision Dilemma. Asian Pac J Cancer Prev. 2016; 17(4):1617-23. DOI: 10.7314/apjcp.2016.17.4.1617. View

Rawat S, Srivastava H, Ahlawat P, Pal M, Gupta G, Chauhan D . Weekly versus Three-Weekly Cisplatin-based Concurrent Chemoradiotherapy as definitive treatment in Head and Neck Cancer- Where do we stand?. Gulf J Oncolog. 2016; 1(21):6-11. View

Guan J, Zhang Y, Li Q, Zhang Y, Li L, Chen M . A meta-analysis of weekly cisplatin versus three weekly cisplatin chemotherapy plus concurrent radiotherapy (CRT) for advanced head and neck cancer (HNC). Oncotarget. 2016; 7(43):70185-70193. PMC: 5342545. DOI: 10.18632/oncotarget.11824. View

Gupta T, Agarwal J, Ghosh-Laskar S, Parikh P, DCruz A, Dinshaw K . Radical radiotherapy with concurrent weekly cisplatin in loco-regionally advanced squamous cell carcinoma of the head and neck: a single-institution experience. Head Neck Oncol. 2009; 1:17. PMC: 2702367. DOI: 10.1186/1758-3284-1-17. View

10.

Bauml J, Vinnakota R, Anna Park Y, Bates S, Fojo T, Aggarwal C . Cisplatin Every 3 Weeks Versus Weekly With Definitive Concurrent Radiotherapy for Squamous Cell Carcinoma of the Head and Neck. J Natl Cancer Inst. 2018; 111(5):490-497. PMC: 6510226. DOI: 10.1093/jnci/djy133. View

11.

Espeli V, Zucca E, Ghielmini M, Giannini O, Salatino A, Martucci F . Weekly and 3-weekly cisplatin concurrent with intensity-modulated radiotherapy in locally advanced head and neck squamous cell cancer. Oral Oncol. 2011; 48(3):266-71. DOI: 10.1016/j.oraloncology.2011.10.005. View

12.

Seiwert T, Salama J, Vokes E . The chemoradiation paradigm in head and neck cancer. Nat Clin Pract Oncol. 2007; 4(3):156-71. DOI: 10.1038/ncponc0750. View

13.

Colevas A . Commentary on "Weekly Low-Dose Versus Three-Weekly High-Dose Cisplatin for Concurrent Chemoradiation in Locoregionally Advanced Non-Nasopharyngeal Head and Neck Cancer: A Systematic Review and Meta-Analysis of Aggregate Data". Oncologist. 2017; 22(9):1022-1023. PMC: 5599207. DOI: 10.1634/theoncologist.2017-0232. View

14.

Fayette J, Molin Y, Lavergne E, Montbarbon X, Racadot S, Poupart M . Radiotherapy potentiation with weekly cisplatin compared to standard every 3 weeks cisplatin chemotherapy for locoregionally advanced head and neck squamous cell carcinoma. Drug Des Devel Ther. 2015; 9:6203-10. PMC: 4664534. DOI: 10.2147/DDDT.S81488. View

15.

Noronha V, Joshi A, Patil V, Agarwal J, Ghosh-Laskar S, Budrukkar A . Once-a-Week Versus Once-Every-3-Weeks Cisplatin Chemoradiation for Locally Advanced Head and Neck Cancer: A Phase III Randomized Noninferiority Trial. J Clin Oncol. 2017; 36(11):1064-1072. DOI: 10.1200/JCO.2017.74.9457. View

16.

Pignon J, Bourhis J, Domenge C, Designe L . Chemotherapy added to locoregional treatment for head and neck squamous-cell carcinoma: three meta-analyses of updated individual data. MACH-NC Collaborative Group. Meta-Analysis of Chemotherapy on Head and Neck Cancer. Lancet. 2000; 355(9208):949-55. View

17.

Helfenstein S, Riesterer O, Meier U, Papachristofilou A, Kasenda B, Pless M . 3-weekly or weekly cisplatin concurrently with radiotherapy for patients with squamous cell carcinoma of the head and neck - a multicentre, retrospective analysis. Radiat Oncol. 2019; 14(1):32. PMC: 6371614. DOI: 10.1186/s13014-019-1235-y. View

18.

Mackiewicz J, Rybarczyk-Kasiuchnicz A, Lasinska I, Mazur-Roszak M, Swiniuch D, Michalak M . The comparison of acute toxicity in 2 treatment courses: Three-weekly and weekly cisplatin treatment administered with radiotherapy in patients with head and neck squamous cell carcinoma. Medicine (Baltimore). 2018; 96(51):e9151. PMC: 5758147. DOI: 10.1097/MD.0000000000009151. View