Dose intensity comparison between weekly and 3-weekly Cisplatin delivered concurrently with radical radiotherapy for head and neck cancer: A retrospective comparison from New Cross Hospital, Wolverhampton, UK

Figures & data

Table I.  Patient and treatment details.

	Weekly Cisplatin (n = 24)	3 weekly Cisplatin (n = 27)
T Staging
T1	6 (25%)	3 (11%)
T2	2 (8%)	4 (15%)
T3	4 (17%)	2 (7%)
T4	10 (41%)	16 (59%)
Tx (recurrent or UKP)	2 (8%)	2 (7%)
N Staging
N0	0	3
N1	1	0
N2	16	15
N3	6	8
Nx	0	1
Site
Oropharynx	14	14
Hypopharynx	4	4
Larynx	4	1
Nasopharynx	0	7
Unknown primary	0	1
Neck recurrence	0	1
Chemotherapy
Concurrent Cisplatin Dose	20 (40 mg/m^2)	7 (100 mg/m^2)
	4 (33 mg/m^2)	20 (80 mg/m^2)
Radiotherapy Dose Fractionation
70Gy/35#	0	2
66GY/30#	23	23
60Gy/30#	1 (stomal recurrence)	0
Unable to complete	0	2

Table II.  Cisplatin dose intensity.

	Weekly Cisplatin 40 mg/m^2	3-weekly Cisplatin 80 mg/m^2	3-weekly Cisplatin 100 mg/m^2
	n = 20	n = 20	n = 7	P-value
Neoadjuvant Cisplatin/ 5FU	10 (50%)	5 (25%)	3 (43%)	0.11
Total Cisplatin delivered	4034 mg/m^2	4069 mg/m^2	1260 mg/m^2
Dose reduction	4 (17%)	2 (10%)	2 (29%)
Mean Cisplatin dose	202 mg/m^2	203 mg/^2	180 mg/m2^2	0.39
Cumulative dose achieved ≥200 mg/m^2	13 (65%)	12 (60%)	4 (57%)	0.91
Cumulative dose achieved ≥240 mg/m^2	9 (45%)	11 (55%)	0	0.04

Table III.  Radiotherapy overall treatment time.

	*Weekly Cisplatin (n = 23)	*3 weekly Cisplatin (n = 23)	P-value
Range	43–54 days	45–57 days
Median	45 days	46 days	0.26
Delay	10 (42%)	12 (44%)	0.77

*Excluded patients unable to complete radiotherapy due to death (n = 2), receiving 30 or 35 fractions.

Table IV.  Treatment toxicity (no. of patients).

	Weekly Cisplatin (n = 24)	3 weekly Cisplatin (n = 27)	P-value
Haematological
Anaemia (Grade 1/2)	20	20	0.64
Neutropenia (Grade 3)	5	6	0.83
Neutropenic fever	2	5	0.33
Renal
Grade 1/2	5	5	0.89
Gastrointestinal
Vomitting (Grade 3)	2	6	0.33
Constipation (Grade 3)	1	1	0.33
NG/PEG tube
• during treatment	22/24 (92%)	27/27 (100%)	0.43
• at 3 months	17/21 (81%)	18/24 (75%)	0.91
• at 12 months	3/19 (16%)	3/16 (19%)	0.83
Neurological
Neuropathy (Grade 1)	3	1	0.52
Skin
Radiation Dermatitis (Grade 3)	13/23 (26%)	6/23 (56%)	0.07