2018
Altered fractionation radiotherapy combined with concurrent low-dose or high-dose cisplatin in head and neck cancer: A systematic review of literature and meta-analysis
SZTURZ, Petr, Kristien WOUTERS, Naomi KIYOTA, Makoto TAHARA, Kumar PRABHASH et. al.Základní údaje
Originální název
Altered fractionation radiotherapy combined with concurrent low-dose or high-dose cisplatin in head and neck cancer: A systematic review of literature and meta-analysis
Autoři
SZTURZ, Petr (203 Česká republika, garant, domácí), Kristien WOUTERS (56 Belgie), Naomi KIYOTA (392 Japonsko), Makoto TAHARA (392 Japonsko), Kumar PRABHASH (356 Indie), Vanita NORONHA (356 Indie), David ADELSTEIN (840 Spojené státy) a Jan B. VERMORKEN (56 Belgie)
Vydání
Oral oncology, AMSTERDAM, ELSEVIER SCIENCE BV, 2018, 1368-8375
Další údaje
Jazyk
angličtina
Typ výsledku
Článek v odborném periodiku
Obor
30204 Oncology
Stát vydavatele
Nizozemské království
Utajení
není předmětem státního či obchodního tajemství
Impakt faktor
Impact factor: 3.730
Kód RIV
RIV/00216224:14110/18:00103957
Organizační jednotka
Lékařská fakulta
UT WoS
000418885000008
Klíčová slova anglicky
Head and neck cancer; Concurrent chemoradiotherapy; Meta-analysis; Radiotherapy dose fractionation; Cisplatin; Survival
Příznaky
Mezinárodní význam, Recenzováno
Změněno: 9. 2. 2019 20:15, Soňa Böhmová
Anotace
V originále
Objectives: Altered fractionation radiotherapy and concomitant chemoradiotherapy represent commonly used intensification strategies in the management of locally advanced squamous cell carcinoma of the head and neck (LA-SCCHN). This meta-analysis compares compliance, safety, and efficacy between two single-agent cisplatin schedules given concurrently with altered fractionation radiotherapy. Methods: We systematically searched for prospective trials of patients with LA-SCCHN who received post-operative or definitive altered fractionation concurrent chemoradiotherapy. High-dose cisplatin once every three to four weeks (100 mg/m(2), 2 doses) was compared with a weekly low-dose protocol (<= 50 mg/m2, >= 4 doses). The primary outcome was overall survival. The secondary endpoints comprised treatment adherence, acute and late toxicities, and objective response rate. Results: Twelve studies with 1373 patients treated with definitive chemoradiotherapy were included. Compared to the weekly low-dose cisplatin regimen, the three-to four-weekly high-dose cisplatin regimen improved overall survival (p = .0185), was more compliant with respect to receiving all planned cycles of cisplatin (71% versus 95%, p = .0353), and demonstrated less complications in terms of severe (grade 3-4) acute mucositis and/or stomatitis (75% versus 40%, p =. 0202) and constipation (8% versus 1%, p = .0066), toxic deaths (4%, versus 1%, p = .0168), 30-day mortality (8% versus 3%, p = .0154), and severe late subcutaneous fibrosis (21% versus 2%, p < .0001). Overall and complete response rates were similar between both chemotherapy schedules. Conclusion: In chemoradiotherapy incorporating altered fractionation, two cycles of high-dose cisplatin with a three to four week interval are superior to weekly low-dose schedules. Further studies should identify those who might derive the greatest benefit from this intensified approach.