Toxicity of daily low dose cisplatin in radiochemotherapy for locally advanced head and neck cancer

Abstract

Purpose: To evaluate toxicity of radiochemotherapy schedule using daily-low-dose-cisplatin in radiochemotherapy of locally-advanced head-and-neck-cancer (HNSCC). Methods and patients: From October 2003 to October 2006, 50 patients with HNSCC (stage III/IVA/IVB) were treated. In 32 patients, surgery and adjuvant radiotherapy(64 Gy), in 18 patients definitive radiotherapy(70 Gy) was performed. Low-dose-cisplatin was applied concomitantly (6 mg/m2/every radiotherapy-day). Results: Acute toxicity ≥grade 3 was observed in 22 patients (11 patients mucositis/dysphagia, 7 hematologic toxicity, 4 mucositis/dysphagia/hematologic toxicity). 90% of our patients received >80% of the planned cumulative chemotherapy dose, 94% the intended dose of radiotherapy. After median follow-up of 24.2 months, 3-year overall survival and loco-regional control rates were 67.1 and 78%. During follow-up, chronic toxicity ≥grade 3 (xerostomia, subcutaneous fibrosis, or lymphedema) was observed in nine patients. Conclusion: We found chemoradiation with daily-low-dose-cisplatin to be feasible with advantage of low acute and chronic toxicity. Therefore, use of low-dose-cisplatin should be evaluated in future clinical trials.