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

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)
Publication Information
Korean Journal of Head & Neck Oncology / v.27, no.1, 2011 , pp. 47-53 More about this Journal
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.
Keywords
Head and neck cancer; Toxicity; Chemoradiotherapy;
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