Predictive factors of head and neck squamous cell carcinoma patient tolerance to high-dose cisplatin in concurrent chemoradiotherapy

Nakano, Kenji; Sato, Yasuyoshi; Toshiyasu, Takashi; Sato, Yukiko; Inagaki, Lina; Tomomatsu, Junichi; Sasaki, Tōru; Shimbashi, Wataru; Fukushima, Hirofumi; Yonekawa, Hiroyuki; Mitani, Hiroki; Kawabata, Kazuyoshi; Takahashi, Shunji

doi:10.3892/mco.2015.687

Cited by 12 publications

(9 citation statements)

References 32 publications

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“…In cancer specialty hospitals in Japan, 50% of patients receiving this same regimen have been reported to tolerate 3 courses of CDDP, and CR rate was 74%. 6 The present results compared with those data suggest that CRT using generic CDDP can be well tolerated in clinical practice.…”

Section: Discussionsupporting

confidence: 59%

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Chemoradiotherapy With Generic Cisplatin Formulations for Head and Neck Cancers

et al. 2018

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The use of generic drugs has been increasing. However, studies of the safety of generic cisplatin (CDDP) for the treatment of head and neck cancer (HNC) have not been reported. This study investigated the treatment completion rates and incidence of CDDP-related adverse events in patients with advanced HNC treated with concurrent chemoradiotherapy (CRT) using generic CDDP. This study included 72 patients who received concurrent CRT using generic CDDP. The number of courses of CDDP was 3 in 45 patients, 2 in 19 patients, and 1 in 8 patients. During 154 courses of 80 mg/m2 generic CDDP, grade 3/4 leukopenia in 21 (14%), neutropenia in 18 (12%), and hypochromia in 8 (5%) cases were reported. Grade 2 elevated serum creatinine occurred in 4 cases (3%), but no grade 3/4 elevated serum creatinine was reported. These results suggest that CRT using generic CDDP is well tolerated in patients with HNC.

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Section: Discussionsupporting

confidence: 59%

“… 5 However, from the standpoint of clinical tolerance, CDDP 80 mg/m 2 is often used even in cancer specialty hospitals in Japan. 6 Our hospital also uses 80 mg/m 2 .…”

Section: Discussionmentioning

confidence: 99%

Chemoradiotherapy With Generic Cisplatin Formulations for Head and Neck Cancers

et al. 2018

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“…Of the 82 patients analyzed in this study, 21 (26%) patients developed renal impairment (Figure 1B). Previous studies have reported that a cumulative CDDP dose of approximately 200 mg/m 2 or more was sufficient to produce an antitumor effect in patients with head and neck cancer (7,26,27), and the therapeutic goals are set at a cumulative CDDP dose of 200 mg/m 2 or more. In this study, the renal impairment led to a much higher rate of dose reduction or discontinuation of CDDP administration in the second cycle (86% vs. 30%), a much lower completion rate of three cycles in CDDP-RT (24% vs. 75%), and a much lower rate of >200 mg/m 2 of total CDDP dosage (19% vs. 77%) compared to patients who did not develop renal impairment.…”

Section: Discussionmentioning

confidence: 99%

Analysis of Risk Factors for High-dose Cisplatin-induced Renal Impairment in Head and Neck Cancer Patients

Koide

Noda

Okunuki

et al. 2022

In Vivo

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Background/Aim: Concurrent chemoradiotherapy with high-dose cisplatin (CDDP-RT) is the standard therapy for advanced head and neck cancer; however, due to CDDPinduced renal impairment, dose reduction or discontinuation is frequently required. Therefore, the identification of risk factors for renal impairment is of importance to improve the efficacy and safety of CDDP-RT. Patients and Methods: We retrospectively investigated risk factors for renal impairment in advanced head and neck cancer patients receiving CDDP-RT. Renal impairment was defined as a >25% decrease from baseline in estimated glomerular filtration rate within 14 days after CDDP administration in the first cycle. Results: Of the 82 patients analyzed in this study, 21 (26%) patients developed renal impairment. Multivariate logistic regression analysis showed that concomitant use of a calcium channel blocker or lower hemoglobin levels significantly contributed to the increased risk of CDDP-induced renal impairment (odds ratio=3.60, 95% confidence interval=1. 04-12.40; odds ratio=0.71, 95% confidence interval=0.50-0.99, respectively), while concomitant use of proton pump inhibitors was a factor associated with a decreased risk of CDDP-induced renal impairment (odds ratio=0.20, 95% confidence interval=0.04-0. 86). Conclusion: Renal function of patients receiving calcium channel blocker or patients with lower hemoglobin levels should be monitored cautiously when receiving CDDP-RT.Concurrent chemoradiotherapy with high dose-cisplatin (CDDP-RT) is considered to be the standard therapy for advanced head and neck cancer (1-4). The standard CDDP-RT regimen for head and neck cancer consists of three cycles of CDDP at 100 mg/m 2 every 3 weeks and RT (70 Gy for curative treatment and 60-66 Gy for postoperative adjuvant chemotherapy), CDDP is used at higher doses than in regimens for other cancer types, requiring more attention for CDDP-induced toxicity. Despite the many clinical effects of this CDDP-RT therapy, renal impairment results in dose reduction or discontinuation of CDDP. In clinical practice, the completion rate of the CDDP-RT regimen in Japan is lower than that in the West (5-7). Some groups have considered that a reduced dose CDDP-RT regimen is needed because of intolerance in clinical practice (8-10). Therefore, identifying risk factors for renal impairment is of importance to improve the efficacy and safety of CDDP-RT.Acute kidney injury is observed in approximately 30% of CDDP-administered cases (11, 12), and CDDP is known to cause chronic kidney disease because of further progression of renal injury. CDDP is transported to the renal tubules via renal transporters, resulting in renal impairment (13). Previous studies including various cancer types and regimens have shown that female sex, age, hypoalbuminemia, smoking, cardiovascular disease, diabetes, or diagnosis of cancer stage 4 are risk factors for the development of CDDPinduced renal impairment in cancer patients (14, 15). In addition, previous studies on 5-fluorouracil and CDDP therapy have...

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“…In clinical practice, only 50% of patients tolerate the combination of cisplatin at high doses with radiotherapy [23]. This proportion of patients becomes even smaller when we consider that the majority of HNC patients have a low performance status and comorbidities, which are contraindications for cisplatin [24].…”

Section: Discussionmentioning

confidence: 99%

Efficacy and Safety of Cetuximab plus Radiotherapy in Cisplatin-Unfit Elderly Patients with Advanced Squamous Cell Head and Neck Carcinoma: A Retrospective Study

et al. 2019

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Introduction: Concurrent platinum-based chemoradiation currently represents the standard treatment for advanced head and neck cancer (HNC), but it induces a significant toxicity, in particular among elderly patients. Elderly and unfit patients have been underrepresented in clinical trials and there is a need for tailored guidelines. Methods: A retrospective review of clinical data of HNC patients treated at the Operative Oncology Unit of the San Giovanni di Dio Hospital in Frattamaggiore (Naples, Italy) was performed. At study entry, a comprehensive assessment including absolute contraindications for cisplatin use, as well as comorbidities, socioeconomic status, BMI, and weight loss, was performed. The treatment included high-dose radiotherapy plus weekly cetuximab (initially at a dose of 400 mg/m²of body surface area and thereafter at 250 mg weekly during the whole radiotherapy). The aim of this study was to evaluate the activity and toxicity of this schedule in a series of patients aged older than 69 years. Results: Between May 30, 2013, and March 30, 2015, sixty-four patients (age range, 69–87 years; median age, 73.7 years; male/female ratio, 46/18) were treated. The overall response rate was 67% in this series of patients. The disease control rate was 76%. Disease progression was recorded in 25% of the patients. The median duration of loco-regional control was 17 months (range, 15.8–17.7 months). PFS was 14.8 months (range, 13.9–15.5 months). The overall survival was 34 months, with a median follow-up of 41.0 months (range, 31.1–36.8 months). The main grade 3/4 adverse events were acne rash in 52% and radiation dermatitis in 32% of the cases. Conclusion: Cetuximab plus radiotherapy appears to be feasible and active in elderly patients unsuitable for cisplatin treatment. The treatment was supported by a favorable toxicity profile.

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Predictive factors of head and neck squamous cell carcinoma patient tolerance to high-dose cisplatin in concurrent chemoradiotherapy

Cited by 12 publications

References 32 publications

Chemoradiotherapy With Generic Cisplatin Formulations for Head and Neck Cancers

Chemoradiotherapy With Generic Cisplatin Formulations for Head and Neck Cancers

Analysis of Risk Factors for High-dose Cisplatin-induced Renal Impairment in Head and Neck Cancer Patients

Efficacy and Safety of Cetuximab plus Radiotherapy in Cisplatin-Unfit Elderly Patients with Advanced Squamous Cell Head and Neck Carcinoma: A Retrospective Study

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