A comparison of cisplatin cumulative dose and cisplatin schedule in patients treated with concurrent chemo-radiotherapy in nasopharyngeal carcinoma

Gündoğ, Mete; Basaran, Hatice; Bozkurt, Oktay; Eroğlu, Celalettin

doi:10.1016/j.bjorl.2019.04.008

Cited by 14 publications

(27 citation statements)

References 31 publications

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“…In a phase III study Noronha et al demonstrate the superiority of administration of 100 mg/m 2 at three weeks in terms of local control but not in OS, the weekly dose of Cisplatin in this case being 30 mg/m 2 . Increased hospitalization rate (31.1% vs. 11.3%) but also higher rate of adverse events was observed when a three weekly scheme was preferred (84.6% vs. 71.6%) [48][49][50][51][52][53][54][55][56][57][58].…”

Section: Discussionmentioning

confidence: 97%

New Challenges of Treatment for Locally Advanced Head and Neck Cancers in the Covid-19 Pandemic Era

Mireștean

Crişan

Mitrea

et al. 2021

JCM

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Locally advanced head and neck cancer is a unique challenge for cancer management in the Covid-19 situation. The negative consequences of delaying radio-chemotherapy treatment make it necessary to prioritize these patients, the continuation of radiotherapy being indicated even if SARS-CoV-2 infection is confirmed in the case of patients with moderate and mild symptoms. For an early scenario, the standard chemo-radiotherapy using simultaneous integrated boost (SIB) technique is the preferred option, because it reduces the overall treatment time. For a late scenario with limited resources, hypo-fractionated treatment, with possible omission of chemotherapy for elderly patients and for those who have comorbidities, is recommended. Concurrent chemotherapy is controversial for dose values >2.4 Gy per fraction. The implementation of hypo-fractionated regimens should be based on a careful assessment of dose-volume constraints for organs at risks (OARs), using recommendations from clinical trials or dose conversion based on the linear-quadratic (LQ) model. Induction chemotherapy is not considered the optimal solution in this situation because of the risk of immunosuppression even though in selected groups of patients TPF regimen may bring benefits. Although the MACH-NC meta-analysis of chemotherapy in head and neck cancers did not demonstrate the superiority of induction chemotherapy over concurrent chemoradiotherapy, an induction regimen could be considered for cases with an increased risk of metastasis even in the case of a possible Covid-19 pandemic scenario.

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Section: Discussionmentioning

confidence: 97%

New Challenges of Treatment for Locally Advanced Head and Neck Cancers in the Covid-19 Pandemic Era

Mireștean

Crişan

Mitrea

et al. 2021

JCM

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“…In NPC patients, the choice of administering cisplatin dose >200 mg/m 2 is not associated with significant increase of the incidence of AKD. Results from studies by Loong et al 9 and Gundog et al 49 show that overall survival is better at doses >200 mg/m 2 . From the results of those studies, administration of cisplatin with a cumulative dose >200 mg/m 2 produces better outcomes.…”

Section: Discussionmentioning

confidence: 98%

Correlation Between Higher Cumulative Dose of Cisplatin for Concurrent Chemoradiation and Acute Kidney Disease Incidence Among Nasopharyngeal Carcinoma Patients: A Comparative Study

Rachman¹,

Shatri²,

Salamat³

2021

IJGM

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Introduction Nasopharyngeal carcinoma (NPC) is the most malignant cancer in the head and neck area. According to the stage, the management of NPC includes radiation, chemotherapy, or a combination of both. The standard agent for radiosensitizing chemotherapy is cisplatin. Among the several effects of cisplatin administration, nephrotoxicity raises the most concern, especially in high doses. Acute kidney disease (AKD) is a condition in which an acute kidney injury occurs at >7 days but <90 days. This study aimed to assess whether there is a significant difference in the incidence of AKD between NPC patients who received a cumulative dose of cisplatin up to (≤) 200 mg/m 2 and patients who received more than (>) 200 mg/m 2 . Methods This is a cohort retrospective study conducted in the radiotherapy unit of Cipto Mangunkusumo General Hospital. Medical records of 540 patients from January 2014 to December 2018 were collected and sorted. After sorting, 120 of the records were analyzed. Results The analysis showed that 38.4% of patients who received >200 mg/m 2 cumulative dose of cisplatin experienced AKD, whereas 38.3% of the patients who received ≤200 mg/m 2 cumulative dose of cisplatin experienced AKD. Conclusion This study found that in patients with locally advanced NPC who received cisplatin chemoradiation, there was no significant difference in the incidence of AKD, recovery of renal function, or progression of chronic kidney disease between patients receiving a cumulative dose of cisplatin ≤200 mg/m 2 and those receiving >200 mg/m 2 .

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“…Similar to SCCHN, some studies reported that weekly cisplatin concurrent with radiotherapy resulted in similar efficacy and toxicity as triweekly cisplatin in patients with NPC. [15–19] However, the results were not reported consistent in NPC. The study by Wang et al [20] reported that the 5-year DFS and 5-year OS of weekly cisplatin were significantly better than those of triweekly cisplatin (96.7% vs 88.3%, P = .036 and 90.7% vs 80.5%, P = .028, respectively) in NPC.…”

Section: Introductionmentioning

confidence: 90%

Efficacy and safety of weekly versus triweekly cisplatin concurrent with radiotherapy in nasopharyngeal carcinoma: A meta-analysis

Chen

et al. 2022

Medicine

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Background: Cisplatin-based concurrent chemoradiotherapy is a standard of care for locally advanced nasopharyngeal carcinoma (NPC), and weekly and triweekly cisplatin are both alternative regimens based on the results of squamous cell carcinoma of the head and neck. However, there is a lack of direct evidence on the efficacy and safety of weekly versus triweekly cisplatin concurrent with radiotherapy in NPC alone. This meta-analysis aimed to identify which regimen is more superior between weekly and triweekly cisplatin in patients with NPC treated with concurrent chemoradiotherapy. Methods: The PubMed, Embase, and Cochrane Library were searched for eligible literatures. Clinical outcome measures including 1-year overall survival (OS), 3-year OS, 5-year OS, 5-year loco-regional failure-free survival, 5-year distant metastasis-free survial and the most common 3 grade or higher acute toxicities (hematological toxicity, mucositis and nausea and vomiting) were analyzed by RevMan 5.4 software; significance level was 0.05. Results: Seven clinical controlled studies with 1795 patients were included in the meta-analysis. There were no significant differences between weekly and triweekly cisplatin in 1-year OS, 3-year OS, 5-year OS, 5-year loco-regional failure-free survival, and 5-year distant metastasis-free survial) (all P > .05). Grade 3 or higher mucositis and nausea and vomiting showed similar between the 2 arms. However, grade 3 or higher hematological toxicity of weekly cisplatin was significantly higher than that of triweekly cisplatin (1.55; 95% CI, 1.22–1.98, P = .0004). Conclusions: Weekly cisplatin resulted in similar survival benifit as triweekly cisplatin, but with higher hematological toxicity.

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A comparison of cisplatin cumulative dose and cisplatin schedule in patients treated with concurrent chemo-radiotherapy in nasopharyngeal carcinoma

Cited by 14 publications

References 31 publications

New Challenges of Treatment for Locally Advanced Head and Neck Cancers in the Covid-19 Pandemic Era

New Challenges of Treatment for Locally Advanced Head and Neck Cancers in the Covid-19 Pandemic Era

Correlation Between Higher Cumulative Dose of Cisplatin for Concurrent Chemoradiation and Acute Kidney Disease Incidence Among Nasopharyngeal Carcinoma Patients: A Comparative Study

Efficacy and safety of weekly versus triweekly cisplatin concurrent with radiotherapy in nasopharyngeal carcinoma: A meta-analysis

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