Klin Onkol 2007; 20(3): 248-252.
Backgrounds: Evaluation of the toxicity and efficacy of chemoradiotherapy with weekly cisplatin in loco(regional) advanced head
and neck cancer. Design and Subjects: Between 1/02 and 11/05, 103 consecutive patients (pts.) were treated. Tumors of the oropharynx
were the most frequent and stage IV was predominant (85%). Radiotherapy consisted of 70 Gy/7 weeks/35 fractions, or 72
Gy/6 weeks/concomitant boost in pts. with or without R1/2 resection, or 60 Gy/6 weeks/30 fraction after R0 resection. All patients
received concurrent chemotherapy with cisplatinum 40 mg/m2 weekly. Methods and Results: 87% pts. received the full planned dose
of radiation therapy. Median total tumor dose was 70 Gy, median number of chemotherapy courses was 5. Grade 3/4 mucosal toxicity
developed in 34%, and grade 3/4 neutropenia in 30%, representing the most frequent reason for the termination of chemotherapy. The
late toxicities were acceptable, comprising predominantly subcutaneous fibrosis and 1/2 grade xerostomia in most cases. Out of the
87 pts. in whom the response could be evaluated, 84% reached complete remission. 1- and 2-year estimated loco-regional control was
reached in 79% and 60%, 1- and 2-year overall survival in 64% and 52%, 1- and 2-year symptom free survival in 59% and 46% of
cases, respectively. Conclusions: Concomitant chemoradiotherapy with weekly cisplatinum is toxic, but tolerable and highly active
in terms of initial response. Despite these facts, the overall survival of patients remains poor. For definitive conclusions long term follow-
up is necessary.
