The aim of this study is to analyze the results of over 10 years experience with postoperative radiochemotherapy in patients diagnosed of locally advanced squamous cell carcinoma of head and neck based in cisplatin 40mg/m2/week.
From March 2004 to August 2015, 104 patients were treated in our department. All patients received chemoradiation therapy with adjuvant intent based in the same scheme: radiotherapy 50 Gy to clinical target volume (CTV) and 66-70 Gy to areas with close margin or extracapsular lymph node involvement and weekly cisplatin at 40mg/m2 concomitant to radiotherapy.
The median age was 59 years (range 36-76), 85 patients were male (81.7%) and 19 were female (18.3%). The pathological stage was: 2.9 stage II, 8.7% stage III and 88.4% stage IV. Locations: 38.5% larynx, 38.5% oral cavity, 17.3% oropharynx, and 5.8% hypopharynx. 76.2% of patients received at least 5 cycles of chemotherapy. G3 toxicity was observed in 33% of patients being mucositis and epitelitis the most frecuents. G4 toxicity was not detected in any patient. Median follow-up was 81 months (range 18-137). Two-year and five-year overall survival (OS) were 90% and 76% respectively and disease-free survival (DFS) were 69.07% and 52.57% respectively. In multivariate analysis two or more positive nodes and longer time between surgery and onset of radiotherapy were significant predictors of poorer OS and extracapsular extension, positive margin and longer time between surgery and onset of radiotherapy were significant predictors of poorer DFS.
In our serie, postoperative radiochemotherapy based in weekly cisplatin at 40mg/m2 in patients diagnosed of locally advanced squamous cell carcinoma of head and neck offers a good toxicity profile and results comparable to those published in the literature with 3-weekly cisplatin scheme. The number of positive nodes, longer time between surgery and onset of radiotherapy, extracapsular extension and positive margin were desfavorable prognostic factor related with SLE and OS in the multivariate analysis.
Clinical trial identification
Legal entity responsible for the study
Hospital Ramón y Cajal
All authors have declared no conflicts of interest.