Abstract 5271
Background
Although CCRT with high-dose cisplatin remains the standard protocol for patients with LA-NPC, carboplatin has been alternatively used especially for cisplatin-ineligible patients. However, the comparable efficacy of these 2 regimens is still unclear. This study aimed to compare the efficacy and tolerability of 3-weekly carboplatin with 3-weekly cisplatin.
Methods
From May 2005 to November 2014, we retrospectively reviewed medical information for 787 LA-NPC patients treated with CCRT from 3 university hospitals in Thailand. Chemotherapy regimen would be either cisplatin (75-100 mg/m2) or carboplatin (AUC-5 or 6), followed by adjuvant chemotherapy (platinum plus 5-fluorouracil). Tolerability and survival were analyzed and compared.
Results
Patient demographics, baseline characteristics, and treatment for the patients was shown in the table. During CCRT, 52% of patients in the cisplatin arm completed the 3 planned cycles of treatment, compared to 88% in the carboplatin arm (P < 0.0001). Fifty-six percent of patients in the cisplatin, whereas only 5% in the carboplatin arm required dose reduction of chemotherapy due to toxicities (P < 0.0001). At the time of analysis, the 5-year disease-free survival was 60% (95% confidence interval [CI], 56 to 63) and 62% (95% CI, 50 to 72) (P = 0.21), and 5-year overall survival was 74% (95% CI, 70 to 77) and 67% (95% CI, 56 to 77) (P = 0.19), in the cisplatin and carboplatin groups, respectively.Table: 1076P
| Variables | Treatment group | P-value | |
|---|---|---|---|
| Cisplatin (n = 710) | Carboplatin (n = 77) | ||
| Median age (years) | 50 | 48 | 0.915 |
| Sex [n (%)] Male | 500 (70) | 56 (73) | 0.391 |
| Smoking Yes [n (%)] | 225 (32) | 47 (61) | <0.0001 |
| Comorbidity Yes [n (%)] | 96 (14) | 18 (23) | 0.019 |
| Stage I [n (%)] II [n (%)] III [n (%)] IVa-IVb [n (%)] | 2 (0.3) 110 (15.6) 289 (41) 308 (43) | 1 (1) 11 (15) 28 (36) 37 (48) | 0.454 |
| WHO classification I [n (%)] II [n (%)] III [n (%)] Missing [n (%)] | 5 (0.7) 206 (29) 161 (22.7) 338 (47.6) | 0 (0) 39 (51) 38 (49) 0 (0) | 0.401 |
| Median baseline Cr (mg%) | 0.87 | 0.94 | <0.0001 |
Conclusions
Carboplatin showed similar efficacy to that of cisplatin with better tolerability and could be used as an alternative regimen.
Clinical trial identification
Legal entity responsible for the study
Research University Network: Head and Neck Working Group.
Funding
Research University Network (Thailand).
Editorial Acknowledgement
Disclosure
All authors have declared no conflicts of interest.
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