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

J 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.

Basic information

Original name

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

Authors

SZTURZ, Petr (203 Czech Republic, guarantor, belonging to the institution), Kristien WOUTERS (56 Belgium), Naomi KIYOTA (392 Japan), Makoto TAHARA (392 Japan), Kumar PRABHASH (356 India), Vanita NORONHA (356 India), David ADELSTEIN (840 United States of America) and Jan B. VERMORKEN (56 Belgium)

Edition

Oral oncology, AMSTERDAM, ELSEVIER SCIENCE BV, 2018, 1368-8375

Other information

Language

English

Type of outcome

Článek v odborném periodiku

Field of Study

30204 Oncology

Country of publisher

Netherlands

Confidentiality degree

není předmětem státního či obchodního tajemství

Impact factor

Impact factor: 3.730

RIV identification code

RIV/00216224:14110/18:00103957

Organization unit

Faculty of Medicine

DOI

http://dx.doi.org/10.1016/j.oraloncology.2017.11.025

UT WoS

000418885000008

Keywords in English

Head and neck cancer; Concurrent chemoradiotherapy; Meta-analysis; Radiotherapy dose fractionation; Cisplatin; Survival

Abstract

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.

Citovat

SZTURZ, Petr, Kristien WOUTERS, Naomi KIYOTA, Makoto TAHARA, Kumar PRABHASH, Vanita NORONHA, David ADELSTEIN and Jan B. VERMORKEN. 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. Oral oncology. AMSTERDAM: ELSEVIER SCIENCE BV, 2018, vol. 76, JAN 2018, p. 52-60. ISSN 1368-8375. Available from: https://dx.doi.org/10.1016/j.oraloncology.2017.11.025.

@article{1446336,
   author = {Szturz, Petr and Wouters, Kristien and Kiyota, Naomi and Tahara, Makoto and Prabhash, Kumar and Noronha, Vanita and Adelstein, David and Vermorken, Jan B.},
   article_location = {AMSTERDAM},
   article_number = {JAN 2018},
   doi = {http://dx.doi.org/10.1016/j.oraloncology.2017.11.025},
   keywords = {Head and neck cancer; Concurrent chemoradiotherapy; Meta-analysis; Radiotherapy dose fractionation; Cisplatin; Survival},
   language = {eng},
   issn = {1368-8375},
   journal = {Oral oncology},
   title = {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},
   volume = {76},
   year = {2018}
}

TY  - JOUR
ID  - 1446336
AU  - Szturz, Petr - Wouters, Kristien - Kiyota, Naomi - Tahara, Makoto - Prabhash, Kumar - Noronha, Vanita - Adelstein, David - Vermorken, Jan B.
PY  - 2018
TI  - 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
JF  - Oral oncology
VL  - 76
IS  - JAN 2018
SP  - 52-60
EP  - 52-60
PB  - ELSEVIER SCIENCE BV
SN  - 13688375
KW  - Head and neck cancer
KW  - Concurrent chemoradiotherapy
KW  - Meta-analysis
KW  - Radiotherapy dose fractionation
KW  - Cisplatin
KW  - Survival
N2  - 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.
ER  -

SZTURZ, Petr, Kristien WOUTERS, Naomi KIYOTA, Makoto TAHARA, Kumar PRABHASH, Vanita NORONHA, David ADELSTEIN and Jan B. VERMORKEN. 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. \textit{Oral oncology}. AMSTERDAM: ELSEVIER SCIENCE BV, 2018, vol.~76, JAN 2018, p.~52-60. ISSN~1368-8375. Available from: https://dx.doi.org/10.1016/j.oraloncology.2017.11.025.

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