Concurrent chemoradiotherapy (CRT) with single agent cisplatin for patients with head and neck cancers (HNC) have been used as the standard treatment for a long time. Although recommended dose of cisplatin is 100mg/m2, we sometimes reduced cisplatin dose to 80mg/m2 depends on general condition in real world setting. It remains unclear whether the efficacy and the safety, especially in nephrotoxicity, for CRT of HNC patients with cisplatin dose 100mg/m2 or 80mg/m2 are different.
We reviewed medical records of NHC patients who received CRT in our institute retrospectively. The primary objectives of this study were to evaluate the nephrotoxicity and the rate of patients treated with cumulative dose of cisplatin 200mg/m2 or more.
During January 2014 to October 2017, 261 HNC patients who received CRT were treated. The starting dose of cisplatin were 80mg/m2 in 118 patients vs 100mg/m2 in 143 patients, respectively. There were more patients over 70 years who received cisplatin in 80mg/m2 than 100mg/m2 (27.1% vs 4.2%, p < 0.001). The mean Creatinine Clearance (Ccr) obtained using the Cockcroft-Gaut at baseline was significantly lower in 80mg/m2 than 100mg/m2 (87.82 vs 97.28, p = 0.0022). There were no significantly differences in patient’s other characteristics as follows gender, performance states, pathology. The incidence of Grade 2 or higher elevation in creatinine was 2 (1.7%) in 80mg/m2 group and 4 (2.8%) in 100mg/m2 group, respectively (p = 0.554). The rate of change in CCR showed no difference between both groups (-5.73% in 80mg/m2 vs -7.63% in 100mg/m2, p = 0.2927), either. The rate of cumulative dose of cisplatin ≧200mg/m2 was significantly higher in 100mg/m2 than 80mg/m2 (97.2% vs 72.0%, p < 0.001). 2-year PFS rate was not significantly different between 80 mg/m2and 100 mg/m2 in oropharynx (89.3% vs 88.2%, p = 0.7760) and in hypopharynx/ larynx (70.28% vs 80.92%, p = 0.4740), respectively.
Cisplatin dose of CRT for HNC patients in 100mg/m2was feasible without increasing the nephrotoxicity and the rate of cumulative dose of cisplatin ≧ 200mg/m2was higher compared to 80mg/m2.
Clinical trial identification
The study protocol was approved by the local institutional review board (approval no. 2017-1197) and conducted in accordance with the provisions of the Declaration of Helsinki and local regulations.
Legal entity responsible for the study
Has not received any funding.
All authors have declared no conflicts of interest.