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Background  To compare definitive radiochemotherapy with weekly administration of 30–40 mg/m 2  of cisplatin to 100 mg/m 2  of cisplatin on days 1, 22 and 43 for outcomes and toxicity in patients with squamous cell carcinoma of the head-and-neck.    Methods  Seventy-five patients receiving radiochemotherapy with weekly cisplatin (30–40 mg/m 2 ) were compared to 58 patients receiving radiochemotherapy with 100 mg/m 2  cisplatin on days 1, 22 and 43. Radiochemotherapy regimen plus seven characteristics (age, gender, performance score, tumor site, T-/N-category, histologic grading) were evaluated for locoregional control (LRC), metastases-free survival (MFS) and overall survival (OS). Radiochemotherapy groups were compared for toxicity.    Results  On multivariate analysis, improved LRC was associated with cisplatin 100 mg/m 2  (hazard ratio [HR] 1.57;  p  = 0.008) and female gender (HR 4.37;  p  = 0.003). Radiochemotherapy regimen was not significantly associated with MFS on univariate analysis ( p  = 0.66). On multivariate analysis, better MFS was associated with ECOG performance score 0–1 (HR 5.63;  p  < 0.001) and histological grade 1–2 (HR 1.81;  p  = 0.002). On multivariate analysis, improved OS was associated with cisplatin 100 mg/m 2  (HR 1.33;  p  = 0.023), ECOG performance score 0–1 (HR 2.15;  p  = 0.029) and female gender (HR 1.98;  p  = 0.026). Cisplatin 100 mg/m 2  was associated with higher rates of grade ≥3 hematotoxicity ( p  = 0.004), grade ≥2 renal failure ( p  = 0.004) and pneumonia/sepsis ( p  = 0.033).    Conclusions  Radiochemotherapy with 100 mg/m 2  of cisplatin every 3 weeks resulted in better LRC and OS than weekly doses of 30–40 mg/m 2 . Given the limitations of a retrospective study, 100 mg/m 2  of cisplatin appears preferable. Since this regimen was associated with considerable acute toxicity, patients require close monitoring.

bmc cancer

Comparison of weekly administration of cisplatin versus three courses of cisplatin 100 mg/m2 for definitive radiochemotherapy of locally advanced head-and-neck cancers