Acute Toxicity in Head and Neck Squamous Cell Carcinoma During Treatment with Tri-weekly VS Weekly Cisplatin CCRT, A Randomized Controlled Trial

Abstract

Background: Head and neck cancer there are more than 550,000 annual incidents worldwide, of which approximately 90% are squamous cell carcinoma. Most patients are referred to the physician when the disease progresses.

Objective: This study was aimed to compare the acute toxicity during treatment of 30-40 mg/m² weekly versus 80-100 mg/m² tri-weekly cisplatin based concurrent chemoradiation therapy regimens in locally advanced non-nasopharyngeal head and neck cancer patients.

Materials and Methods: From January 2017- December 2017, the study enrolled 40 patients with locally advanced head and neck squamous cell carcinoma. Patients were randomly assigned into 2 treatment regimens, either concurrent chemoradiation with tri-weekly cisplatin (ARM A) or weekly cisplatin (ARM B). The acute toxicity and compliance during treatment were analyzed.

Results: Acute toxicity profiles by NCI CTCAE 4.03 grading of both regimens were not statistically significant difference. Statistical similar rate of optimal target dose acquired of both regimens. Tri-weekly regimen associated with significant more weight loss at 4^th and the last week of treatment, p = 0.011 and p = 0.047 respectively. Chemotherapy completion rate was higher in weekly cisplatin, p = 0.043. Treatment compliance was lower than the reviewed data.

Conclusions: In our study, the acute toxicity outcomes of weekly cisplatin regimen were not superior to that of cisplatin triweekly regimens by NCI CTCAE 4.03 grading system. Cisplatin weekly regimen associated with same optimal target dose acquired, statistical similar acute toxicity profiles, higher completion rate and less weight loss. Our study suggests that concurrent chemoradiation with weekly cisplatin is feasible in clinical practice.