An optimal cumulative dose of cisplatin in chemoradiotherapy as a definitive treatment for non-metastatic nasopharyngeal carcinoma: a retrospective multicenter study

Background

To date, there is no recommended optimal cumulative dose (OCD) of cisplatin in definitive chemoradiotherapy (CRT) for non-metastatic nasopharyngeal carcinoma (NPC). We conducted a retrospective study to determine a MCCD in NPC treated with CRT.

Methods

Histologically confirmed non-metastatic NPC patients treated at the Ramathibodi and Siriraj Hospitals between 2007 and 2015 were identified. Baseline patient characteristics, treatment modality and survivals were abstracted. The OCD of cisplatin >200 mg/m2 was used as a stratification dose level. Primary end point was 3-year survival (OS). The Kaplan-Meier with log-rank test were used for analysis. A p-value

Results

Total of 289 NPC patients were included for analysis. Two hundred and thirty one patients received OCD of cisplatin >200 mg/m2, while 58 patients did not. Median age was 52 (range 17-75). Median radiation dose was 6996 cGY (range 1440-7840). Median cisplatin dose was 240 mg/m2 (range 75-361). There was no statistical difference in demographics between these 2 groups, except radiation interruption was more common in patients who received ODC of cisplatin >200 mg/m2 (27% vs 3%, p 

Conclusions

Our study demonstrated no significant difference in 3 year OS and DFS between OCD of cisplatin greater or lesser than 200 mg/m2. A prospective study comparing standard vs lower dose of cisplatin is warranted to minimize cisplatin related toxicity during chemoradiotherapy for NPC.

Clinical trial identification

Legal entity responsible for the study

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Funding

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Disclosure

All authors have declared no conflicts of interest.