Compliance, toxicity and efficacy in weekly versus 3-weekly cisplatin concurrent chemoradiation in locally advanced head and neck cancer

AimWeekly low-dose cisplatin is routinely used in concurrent chemoradiation (CCRT) in locally advanced head and neck cancer (LAHNC), despite 3-weekly cisplatin being the standard of care. We compared compliance, toxicity and efficacy in weekly versus 3-weekly cisplatin CCRT in LAHNC.Materials and methodsIn this retrospective study, weekly cisplatin 50 mg flat dose was compared with 3-weekly cisplatin 100 mg/m(2), when given in CCRT in LAHNC with curative intent. The study outcome was compliance, toxicity, loco-regional control (LRC), disease-free survival (DFS) and overall survival (OS).ResultsEighty-four patients received CCRT from January 2013 to June 2017, 40 in weekly and 44 in 3-weekly arm. There was no difference between the arms not completing scheduled radiation therapy or chemotherapy. Patient receiving 200 mg/m(2) cisplatin is higher in 3-weekly arm compared with weekly arm (75 versus 409%; p<00015). Compared with 3-weekly arm, more patient in weekly arm developed grade 3 mucositis (525 versus 159%, p=00004), day care intravenous hydration (825 versus 386% <00001) and in-patient admission (550 versus 182%; p=00004). The 2-year LRC, DFS and OS in weekly versus 3-weekly arm were: 70 versus 614% (p=0406); 675 versus 568% (p=0314); 675 versus 614% (p=0558), respectively. The median time to LRR, DFs and OS was not reached.ConclusionsWeekly cisplatin is comparable with 3-weekly cisplatin in terms of compliance, disease control and survival, but with increased grade 3 mucositis and higher admissions for supportive care.