Weekly Low-Dose Versus Three-Weekly High-Dose Cisplatin for
Concurrent Chemoradiation in Locoregionally Advanced
Non-Nasopharyngeal Head and Neck Cancer: A Systematic Review
and Meta-Analysis of Aggregate Data

J 2017

Weekly Low-Dose Versus Three-Weekly High-Dose Cisplatin for Concurrent Chemoradiation in Locoregionally Advanced Non-Nasopharyngeal Head and Neck Cancer: A Systematic Review and Meta-Analysis of Aggregate Data

SZTURZ, Petr; K. WOUTERS; N. KIYOTA; M. TAHARA; K. PRABHASH et. al.

Basic information

Original name

Weekly Low-Dose Versus Three-Weekly High-Dose Cisplatin for Concurrent Chemoradiation in Locoregionally Advanced Non-Nasopharyngeal Head and Neck Cancer: A Systematic Review and Meta-Analysis of Aggregate Data

Authors

SZTURZ, Petr (203 Czech Republic, guarantor, belonging to the institution); K. WOUTERS (56 Belgium); N. KIYOTA (392 Japan); M. TAHARA (392 Japan); K. PRABHASH (356 India); V. NORONHA (356 India); A. CASTRO (620 Portugal); L. LICITRA (380 Italy); D. ADELSTEIN (840 United States of America) and J.B. VERMORKEN (56 Belgium)

Edition

ONCOLOGIST, DURHAM, ALPHAMED PRESS, 2017, 1083-7159

Other information

Language

English

Type of outcome

Article in a journal

Field of Study

30204 Oncology

Country of publisher

United States of America

Confidentiality degree

is not subject to a state or trade secret

References:

URL

Impact factor

Impact factor: 5.306

RIV identification code

RIV/00216224:14110/17:00099895

Organization unit

Faculty of Medicine

DOI

https://doi.org/10.1634/theoncologist.2017-0015

UT WoS

000410656500009

EID Scopus

2-s2.0-85029618980

Keywords in English

Head and neck cancer; Radiotherapy; Cisplatin; Toxicity; Survival

Abstract

In the original language

Background. Three-weekly high-dose cisplatin (100 mg/m(2)) is considered the standard systemic regimen given concurrently with postoperative or definitive radiotherapy in locally advanced squamous cell carcinoma of the head and neck (LA-SCCHN). However, due to unsatisfactory patient tolerance, various weekly low-dose schedules have been increasingly used in clinical practice. The aim of this meta-analysis was to compare the efficacy, safety, and compliance between these two approaches. Materials and Methods. We systematically searched literature for prospective trials of patients with LA-SCCHN who received postoperative or definitive conventionally fractionated concurrent chemoradiation. Radiation doses were usually 60-66 gray (Gy) in the postoperative setting and 6670 Gy in the definitive setting. Standard, three-weekly high-dose cisplatin (100 mg/m(2), 3 doses) was compared with the weekly low-dose protocol (<50 mg/m(2), >6 doses). The primary endpoint was overall survival. Secondary outcomes comprised response rate, acute and late adverse events, and treatment compliance. Results. Fifty-two studies with 4,209 patients were included in two separate meta-analyses according to the two clinical settings. There was no difference in treatment efficacy as measured by overall survival or response rate between the chemoradiation settings with low-dose weekly and high-dose three-weekly cisplatin regimens. In the definitive treatment setting, the weekly regimen was more compliant and significantly less toxic with respect to severe (grade 3-4) myelosuppression (leukopenia p = .0083; neutropenia p = .0024), severe nausea and/or vomiting (p < .0001), and severe nephrotoxicity (p = .0099). Although in the postoperative setting the two approaches were more equal in compliance and with clearly less differences in the cisplatin-induced toxicities, the weekly approach induced more grade 3-4 dysphagia (p = .0026) and weight loss (p < .0001). Conclusion. In LA-SCCHN, current evidence is insufficient to demonstrate a meaningful survival difference between the two dosing regimens. Prior to its adoption into routine clinical practice, the low-dose weekly approach needs to be prospectively compared with the standard three-weekly high-dose schedule.

Cite

SZTURZ, Petr; K. WOUTERS; N. KIYOTA; M. TAHARA; K. PRABHASH; V. NORONHA; A. CASTRO; L. LICITRA; D. ADELSTEIN and J.B. VERMORKEN. Weekly Low-Dose Versus Three-Weekly High-Dose Cisplatin for Concurrent Chemoradiation in Locoregionally Advanced Non-Nasopharyngeal Head and Neck Cancer: A Systematic Review and Meta-Analysis of Aggregate Data. ONCOLOGIST. DURHAM: ALPHAMED PRESS, 2017, vol. 22, No 9, p. 1056-1066. ISSN 1083-7159. Available from: https://doi.org/10.1634/theoncologist.2017-0015.

@article{1406874,
   author = {Szturz, Petr and Wouters, K. and Kiyota, N. and Tahara, M. and Prabhash, K. and Noronha, V. and Castro, A. and Licitra, L. and Adelstein, D. and Vermorken, J.B.},
   article_location = {DURHAM},
   article_number = {9},
   doi = {https://doi.org/10.1634/theoncologist.2017-0015},
   keywords = {Head and neck cancer; Radiotherapy; Cisplatin; Toxicity; Survival},
   language = {eng},
   issn = {1083-7159},
   journal = {ONCOLOGIST},
   title = {Weekly Low-Dose Versus Three-Weekly High-Dose Cisplatin for Concurrent Chemoradiation in Locoregionally Advanced Non-Nasopharyngeal Head and Neck Cancer: A Systematic Review and Meta-Analysis of Aggregate Data},
   url = {https://theoncologist.onlinelibrary.wiley.com/doi/epdf/10.1634/theoncologist.2017-0015?getft_integrator=scopus&src=getftr&utm_source=scopus},
   volume = {22},
   year = {2017}
}

TY  - JOUR
ID  - 1406874
AU  - Szturz, Petr - Wouters, K. - Kiyota, N. - Tahara, M. - Prabhash, K. - Noronha, V. - Castro, A. - Licitra, L. - Adelstein, D. - Vermorken, J.B.
PY  - 2017
TI  - Weekly Low-Dose Versus Three-Weekly High-Dose Cisplatin for Concurrent Chemoradiation in Locoregionally Advanced Non-Nasopharyngeal Head and Neck Cancer: A Systematic Review and Meta-Analysis of Aggregate Data
JF  - ONCOLOGIST
VL  - 22
IS  - 9
SP  - 1056-1066
EP  - 1056-1066
PB  - ALPHAMED PRESS
SN  - 10837159
KW  - Head and neck cancer
KW  - Radiotherapy
KW  - Cisplatin
KW  - Toxicity
KW  - Survival
UR  - https://theoncologist.onlinelibrary.wiley.com/doi/epdf/10.1634/theoncologist.2017-0015?getft_integrator=scopus&src=getftr&utm_source=scopus
N2  - Background. Three-weekly high-dose cisplatin (100 mg/m(2)) is considered the standard systemic regimen given concurrently with postoperative or definitive radiotherapy in locally advanced squamous cell carcinoma of the head and neck (LA-SCCHN). However, due to unsatisfactory patient tolerance, various weekly low-dose schedules have been increasingly used in clinical practice. The aim of this meta-analysis was to compare the efficacy, safety, and compliance between these two approaches. Materials and Methods. We systematically searched literature for prospective trials of patients with LA-SCCHN who received postoperative or definitive conventionally fractionated concurrent chemoradiation. Radiation doses were usually 60-66 gray (Gy) in the postoperative setting and 6670 Gy in the definitive setting. Standard, three-weekly high-dose cisplatin (100 mg/m(2), 3 doses) was compared with the weekly low-dose protocol (<50 mg/m(2), >6 doses). The primary endpoint was overall survival. Secondary outcomes comprised response rate, acute and late adverse events, and treatment compliance. Results. Fifty-two studies with 4,209 patients were included in two separate meta-analyses according to the two clinical settings. There was no difference in treatment efficacy as measured by overall survival or response rate between the chemoradiation settings with low-dose weekly and high-dose three-weekly cisplatin regimens. In the definitive treatment setting, the weekly regimen was more compliant and significantly less toxic with respect to severe (grade 3-4) myelosuppression (leukopenia p = .0083; neutropenia p = .0024), severe nausea and/or vomiting (p < .0001), and severe nephrotoxicity (p = .0099). Although in the postoperative setting the two approaches were more equal in compliance and with clearly less differences in the cisplatin-induced toxicities, the weekly approach induced more grade 3-4 dysphagia (p = .0026) and weight loss (p < .0001). Conclusion. In LA-SCCHN, current evidence is insufficient to demonstrate a meaningful survival difference between the two dosing regimens. Prior to its adoption into routine clinical practice, the low-dose weekly approach needs to be prospectively compared with the standard three-weekly high-dose schedule.
ER  -

SZTURZ, Petr; K. WOUTERS; N. KIYOTA; M. TAHARA; K. PRABHASH; V. NORONHA; A. CASTRO; L. LICITRA; D. ADELSTEIN and J.B. VERMORKEN. Weekly Low-Dose Versus Three-Weekly High-Dose Cisplatin for Concurrent Chemoradiation in Locoregionally Advanced Non-Nasopharyngeal Head and Neck Cancer: A Systematic Review and Meta-Analysis of Aggregate Data. \textit{ONCOLOGIST}. DURHAM: ALPHAMED PRESS, 2017, vol.~22, No~9, p.~1056-1066. ISSN~1083-7159. Available from: https://doi.org/10.1634/theoncologist.2017-0015.

Přehled o publikaci