Comparison of Carboplatin With 5-Fluorouracil vs. Cisplatin as Concomitant Chemoradiotherapy for Locally Advanced Head and Neck Squamous Cell Carcinoma

Autor: Boudewijn E. C. Plaat, Johannes A. Langendijk, Marcel A. T. M. van Vugt, Marije R. Vergeer, Sjoukje F. Oosting, Rudolf S N Fehrmann, Saskia H Hanemaaijer, Jourik A. Gietema, Iris C. Kok, Jan Buter, C. René Leemans, Jens Voortman, Bert van der Vegt
Přispěvatelé: Damage and Repair in Cancer Development and Cancer Treatment (DARE), Guided Treatment in Optimal Selected Cancer Patients (GUTS), Internal medicine, Radiation Oncology, CCA - Cancer Treatment and quality of life, Otolaryngology / Head & Neck Surgery
Jazyk: angličtina
Rok vydání: 2020
Předmět:
0301 basic medicine
Cancer Research
medicine.medical_specialty
medicine.medical_treatment
carboplatin 5-flourouracil
cisplatin
head and neck squamous cell carcinoma
Gastroenterology
area under the concentration-time curve
lcsh:RC254-282
chemoradiotherapy
03 medical and health sciences
chemistry.chemical_compound
CHEMORADIATION
0302 clinical medicine
Internal medicine
RADIATION-THERAPY
medicine
Original Research
Cisplatin
Chemotherapy
business.industry
Hazard ratio
HUMAN-PAPILLOMAVIRUS
CHEMOTHERAPY
medicine.disease
locally advanced head and neck squamous cell carcinoma
lcsh:Neoplasms. Tumors. Oncology. Including cancer and carcinogens
Head and neck squamous-cell carcinoma
Chemotherapy regimen
CANCER
area under the concentration–time curve
Carboplatin
030104 developmental biology
Oncology
chemistry
comparison
030220 oncology & carcinogenesis
Concomitant
TRIAL
business
Chemoradiotherapy
medicine.drug
RADIOTHERAPY
Zdroj: Hanemaaijer, S H, Kok, I C, Fehrmann, R S N, van der Vegt, B, Gietema, J A, Plaat, B E C, van Vugt, M A T M, Vergeer, M R, Leemans, C R, Langendijk, J A, Voortman, J, Buter, J & Oosting, S F 2020, ' Comparison of Carboplatin With 5-Fluorouracil vs. Cisplatin as Concomitant Chemoradiotherapy for Locally Advanced Head and Neck Squamous Cell Carcinoma ', Frontiers in Oncology, vol. 10, 761 . https://doi.org/10.3389/fonc.2020.00761, https://doi.org/10.3389/fonc.2020.00761
Frontiers in Oncology, Vol 10 (2020)
Frontiers in Oncology, 10:761. Frontiers Media SA
Frontiers in Oncology
Frontiers in Oncology, 10:761. Frontiers Media S.A.
ISSN: 2234-943X
Popis: Background: Chemoradiotherapy (CRT) including three cycles of cisplatin is considered the standard of care for locally advanced head and neck squamous cell carcinoma (LA-HNSCC). However, around one-third of the patients cannot complete cisplatin because of toxicity. Carboplatin plus 5-fluorouracil (carbo-5FU) is another accepted treatment option with a different toxicity profile. We compared tolerability and efficacy of concomitant carbo-5FU and cisplatin. Patients and Methods: We conducted a retrospective analysis of LA-HNSCC patients treated with CRT in two Dutch cancer centers between 2007 and 2016. All patients received intensity-modulated radiotherapy. One center routinely administered carboplatin 300–350 mg/m2 at day 1, 22, and 43 followed by 5FU 600 mg/m2/day for 96 h. The other center used cisplatin 100 mg/m2 at day 1, 22, and 43. The primary endpoint of this study was chemotherapy completion rate. Secondary endpoints included overall survival (OS), disease-free survival (DFS), locoregional control (LRC) and distant metastasis–free interval (DMFS), toxicity, and unplanned admissions. Results: In the carbo-5FU cohort (n = 211), 60.2% of the patients completed chemotherapy vs. 76.7% (p < 0.001) of the patients in the cisplatin cohort (n = 223). Univariate analysis showed a higher risk of death in the carbo-5FU cohort [hazard ratio (HR) 1.53, 95% CI, 1.09–2.14, p = 0.01] with a 3-year OS of 65.4 vs. 76.5% for cisplatin. OS was independently associated with T and N stage and p16 status, but not with chemotherapy regimen (HR 1.08, 95% CI, 0.76–1.55, p = 0.65). Three-year DFS was 70.0% for carbo-5FU vs. 78.6% for cisplatin (HR 1.37, 95% CI, 0.93–2.01, p = 0.05). A similar outcome was observed for both LRC (HR 1.27, 95% CI, 0.74–2.09, p = 0.4) and DMFS (HR 1.08, 95% CI 0.62–1.90, p = 0.77). The risk of discontinuation for chemotherapy-associated toxicity was higher in the carbo-5FU cohort than in the cisplatin cohort (relative risk = 1.69). Conclusion: LA-HNSCC patients treated with concomitant carbo-5FU completed chemotherapy less frequently than patients treated with cisplatin. Treatment regimen was not an independent prognostic factor for OS.
Databáze: OpenAIRE
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