Comparison of weekly versus triweekly cisplatin delivered concurrently with radiation therapy in patients with locally advanced nasopharyngeal cancer: A multicenter randomized phase II trial (KCSG-HN10-02).

Abstract

PURPOSE:

Triweekly delivery of cisplatin concurrent with a course of radiation therapy (RT) has been the standard regimen for treatment of locally advanced nasopharyngeal carcinoma (NPC) despite a high level of concern regarding treatment-related complications. We conducted a randomized phase II study to compare weekly and triweekly cisplatin delivery during RT with respect to efficacy and toxicity profiles.

MATERIAL AND METHODS:

Patients with locally advanced NPC (stage II-IVb) were randomly assigned to a regimen of either seven doses of cisplatin (40 mg/m(2)) given once a week or three doses of cisplatin (100mg/m(2)) given every 3 weeks concurrently during RT.

RESULTS:

Of 109 eligible patients, 53 were assigned to the weekly regimen and 56 to the triweekly regimen. The two groups were comparable with respect to demographic and clinical characteristics. There were no significant differences in mean RT dose (68.3 Gy vs. 67.3 Gy, p=0.559) and mean cisplatin dose (248.9 mg/m(2)vs. 256.6 mg/m(2), p=0.433) between the two regimens. The primary endpoint was 3-year progression-free survival, which was not different between the regimens (64.9% vs. 63.8%, p=0.074). Overall, the occurrence of grade 3-4 toxicities was similar between the two arms (47.2% vs. 39.3%, p=0.443). Quality of life (QoL) related to functional outcomes 3 weeks after treatment completion was better for the weekly regimen.

CONCLUSIONS:

Although no definitive conclusions can be made, a once-weekly cisplatin regimen appears to be associated with improved QoL and is not inferior to the standard triweekly regimen with respect to efficacy and toxicity profiles.

• Authors: Ji Yun Lee, Jong-Mu Sun, Dong Ryul Oh, Sung Hee Lim, Juna Goo, Se-Hoon Lee, Sung-Bae Kim, Keon Uk Park, Hoon-Kyo Kim, Dae Sik Hong, Jun Suk Kim, Seong-Geun Kim, Seong Yoon Yi, Hwan Jung Yun, Myung Soo Hyun, Hyo Jung Kim, Sin-Ho Jung, Keunchil Park, Yong Chan Ahn, Myung-Ju Ahn
• Journal: Radiotherapy and oncology : journal of the European Society for Therapeutic Radiology and Oncology (Radiother Oncol) Vol. 118 Issue 2 Pg. 244-50 (Feb 2016) ISSN: 1879-0887 [Electronic] Ireland
• PMID: 26705681 (Publication Type: Clinical Trial, Phase II, Comparative Study, Journal Article, Multicenter Study, Randomized Controlled Trial, Research Support, Non-U.S. Gov't)
• Copyright: Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

Chemical References

• Antineoplastic Agents
• Cisplatin

Topics

• Adult
• Aged
• Antineoplastic Agents (administration & dosage, therapeutic use)
• Carcinoma
• Chemoradiotherapy (methods)
• Cisplatin (administration & dosage, therapeutic use)
• Disease-Free Survival
• Drug Administration Schedule
• Female
• Humans
• Male
• Middle Aged
• Nasopharyngeal Carcinoma
• Nasopharyngeal Neoplasms (therapy)
• Prospective Studies
• Quality of Life
• Treatment Outcome