Amanda Jagdis1, Janessa Laskin, Desiree Hao, John Hay, Jonn Wu, Cheryl Ho. 1. *Department of Medicine, University of British Columbia Departments of †Medical Oncology §Radiation Oncology, British Columbia Cancer Agency, Vancouver, BC ‡Department of Medical Oncology, Tom Baker Cancer Centre, Calgary, AB, Canada.
Abstract
OBJECTIVE: The purpose of this study was to analyze the dose delivery and toxicity of weekly cisplatin versus high-dose cisplatin given every 3 weeks in a tertiary oncology clinic. METHODS: From January 2000 to July 2009, patients with biopsy-proven nasopharyngeal carcinoma receiving concurrent cisplatin with curative-intent radiation therapy (RT) were included. Before 2005, most patients received cisplatin (Q3) (100 mg/m intravenously days 1, 22, and 43 of RT) and 3-dimensional conformal RT (66 Gy, 33 fractions). After 2005, most patients received weekly cisplatin (Q1) (40 mg/m intravenously weekly for 7 wk of RT) and intensity-modulated radiotherapy (70 Gy, 35 fractions). RESULTS: Seventy-three patients were analyzed: 45 for Q1 and 28 for Q3. Cumulative doses ≥200 mg/m were achieved in 80% of Q1 and 86% of Q3 patients, respectively. Dose reduction due to toxicity was required in 2/45 (4%) of Q1 patients compared with 11/28 (39%) of Q3 patients (P=0.0003). Toxicities in Q1 and Q3 patients included: hospitalization for acute toxicity in 20% and 35.7%; mean weight loss 10.85% and 8.75%; percutaneous endoscopic gastrostomy tube placement in 25.6% and 29.6%; and grade 3 dehydration in 11.1% and 17.9%, respectively. Median follow-up time was 3 years for Q1 and 6 years for Q3 patients. Median disease-free survival was 46 months for the Q1 group and 53 months for the Q3 group (P=0.667). There was no difference in overall survival between Q1 and Q3. CONCLUSIONS: In this series, weekly 40 mg/m cisplatin and 3-weekly 100 mg/m cisplatin showed similar deliverability, toxicity profiles, and outcomes. At our center, weekly cisplatin is standard of care for patients with locally advanced nasopharyngeal carcinoma undergoing chemoradiotherapy.
OBJECTIVE: The purpose of this study was to analyze the dose delivery and toxicity of weekly cisplatin versus high-dose cisplatin given every 3 weeks in a tertiary oncology clinic. METHODS: From January 2000 to July 2009, patients with biopsy-proven nasopharyngeal carcinoma receiving concurrent cisplatin with curative-intent radiation therapy (RT) were included. Before 2005, most patients received cisplatin (Q3) (100 mg/m intravenously days 1, 22, and 43 of RT) and 3-dimensional conformal RT (66 Gy, 33 fractions). After 2005, most patients received weekly cisplatin (Q1) (40 mg/m intravenously weekly for 7 wk of RT) and intensity-modulated radiotherapy (70 Gy, 35 fractions). RESULTS: Seventy-three patients were analyzed: 45 for Q1 and 28 for Q3. Cumulative doses ≥200 mg/m were achieved in 80% of Q1 and 86% of Q3 patients, respectively. Dose reduction due to toxicity was required in 2/45 (4%) of Q1 patients compared with 11/28 (39%) of Q3 patients (P=0.0003). Toxicities in Q1 and Q3 patients included: hospitalization for acute toxicity in 20% and 35.7%; mean weight loss 10.85% and 8.75%; percutaneous endoscopic gastrostomy tube placement in 25.6% and 29.6%; and grade 3 dehydration in 11.1% and 17.9%, respectively. Median follow-up time was 3 years for Q1 and 6 years for Q3 patients. Median disease-free survival was 46 months for the Q1 group and 53 months for the Q3 group (P=0.667). There was no difference in overall survival between Q1 and Q3. CONCLUSIONS: In this series, weekly 40 mg/m cisplatin and 3-weekly 100 mg/m cisplatin showed similar deliverability, toxicity profiles, and outcomes. At our center, weekly cisplatin is standard of care for patients with locally advanced nasopharyngeal carcinoma undergoing chemoradiotherapy.
Authors: Vasiliki A Papadimitrakopoulou; Steven J Frank; Ezra W Cohen; Fred R Hirsch; Jeffrey N Myers; John V Heymach; Heather Lin; Hai T Tran; Changhu R Chen; Antonio Jimeno; Lucien Nedzi; Joseph R Vasselli; Elizabeth S Lowe; David Raben Journal: Head Neck Date: 2015-06-16 Impact factor: 3.147
Authors: Anthony Kong; James Good; Amanda Kirkham; Joshua Savage; Rhys Mant; Laura Llewellyn; Joanna Parish; Rachel Spruce; Martin Forster; Stefano Schipani; Kevin Harrington; Joseph Sacco; Patrick Murray; Gary Middleton; Christina Yap; Hisham Mehanna Journal: BMJ Open Date: 2020-03-16 Impact factor: 2.692