The Toxicity and Preliminary Clinical Outcomes of Low-Dose Weekly Cisplatin-Based Concurrent Chemoradiotherapy

두경부암에서 저용량 Cisplatin 기반 매주 요법의 항암방사선 동시치료의 독성과 예비 임상 결과

  • Kim, Tae-Yong (Department of Internal Medicine, Seoul National University Boramae Hospital) ;
  • Kim, Kyoung-Ju (Department of Radiation Oncology, Hallym University Kangnam Sacred Heart Hospital) ;
  • Kim, Ki-Hwan (Department of Internal Medicine, Seoul National University Boramae Hospital) ;
  • Kim, Ji-Eun (Department of Pathology, Seoul National University Boramae Hospital) ;
  • Park, Sun-Won (Department of Radiology, Seoul National University Boramae Hospital) ;
  • Oh, So-Won (Department of Nuclear Medicine, Seoul National University Boramae Hospital) ;
  • Jung, Young-Ho (Department of Otorhinolaryngology-Head and Neck Surgery, Seoul National University Boramae Hospital)
  • 김태용 (서울대학교 보라매병원 내과학교실) ;
  • 김경주 (한림대학교 의과대학 강남성심병원 방사선종양학과) ;
  • 김기환 (서울대학교 보라매병원 내과학교실) ;
  • 김지은 (서울대학교 보라매병원 병리과학교실) ;
  • 박선원 (서울대학교 보라매병원 영상의학과학교실) ;
  • 오소원 (서울대학교 보라매병원 핵의학과학교실) ;
  • 정영호 (서울대학교 보라매병원 이비인후과학교실)
  • Published : 2011.05.27

Abstract

Purpose : Concurrent chemoradiotherapy(CCRT) with 3 weekly cisplatin is the standard treatment of locally advanced head and neck cancer(HNC). The aim is to evaluate the efficacy and toxicities of low-dose weekly cisplatin-based CCRT, which was devised to reduce the toxicity of CCRT. Method : We retrospectively analyzed HNC patients who received low-dose weekly cisplatin-based CCRT between 2008 and 2010. Cisplatin 35mg/$m^2$ was weekly given to all patients during radiotherapy. The efficacy was evaluated by the degree of clinical response, treatment failure and survival. The toxicity was evaluated by hematologic toxicities and oral mucositis. Results : A total of 27 patients were analyzed and median age was 59(range 31-81). The ratio of administered dose of radiotherapy and cisplatin to planned dose were 0.98 and 0.93, respectively. Complete remission and partial remission were 73% and 23%, respectively. Treatment failure was observed in 8(30%) patients. 1-year survival rate and 1-year disease free survival rate were 82% and 59%, respectively. Overall survival and progression-free survival did not reach median time. Grade 3/4 anemia, neutropenia, thrombocytopenia and oral mucositis were observed in 11%, 19%, 7% and 32% of patients, respectively. In terms of administered cycles, however, only 1-3% of grade 3/4 hematologic toxicities occurred among total 190 cycles. Severe oral mucositis were statistically associated with old age(p=0.003). Treatment failure had no statistical relation with age, pathology, primary site and stage. Conclusion : Low-dose weekly cisplatin-based CCRT seemed to deliver enough dose of cisplatin and to show low drop-out rate and good efficacy with low hematologic toxicities.

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