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High‐dose or low‐dose cisplatin concurrent with radiotherapy in locally advanced head and neck squamous cell cancer
Author(s) -
Chang ChiaLun,
Yuan Kevin ShengPo,
Wu SzuYuan
Publication year - 2017
Publication title -
head and neck
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.012
H-Index - 127
eISSN - 1097-0347
pISSN - 1043-3074
DOI - 10.1002/hed.24763
Subject(s) - medicine , head and neck cancer , head and neck squamous cell carcinoma , hazard ratio , chemoradiotherapy , radiation therapy , oncology , confidence interval , mucositis , cisplatin , stage (stratigraphy) , cancer , proportional hazards model , urology , gastroenterology , chemotherapy , paleontology , biology
Background No randomized studies have compared low‐dose or high‐dose concurrent chemoradiotherapy (CRT). Methods In this study, 7219 patients with stage III or IV head and neck squamous cell carcinoma (HNSCC) were enrolled and categorized into 2 groups: group 1, comprising those undergoing low‐dose concurrent CRT (n = 1575), and group 2, comprising those receiving high‐dose concurrent CRT (n = 5644). Results Cox regression analyses revealed that age ≥65 years, male, high Charlson comorbidity index (CCI) scores, radiotherapy (RT) duration ≥7.5 weeks, clinical stage IV cancer, oral cavity cancers, tobacco smoking, and total cisplatin dose ≥240 mg/m 2 were significant independent prognostic risk factors for overall survival (OS). After adjustment for confounders, the adjusted hazard ratio (aHR; 95% confidence interval [CI]) for overall mortality was 0.83 (0.78‐0.89; P < .001) in patients with oral cavity HNSCC undergoing high‐dose concurrent CRT and 0.82 (0.77‐0.94; P < .001) in patients with nonoral cavity HNSCC receiving high‐dose concurrent CRT. Conclusion High‐dose concurrent CRT can reduce the incidence of death in patients with stage III or IV HNSCC.