TY - JOUR
T1 - High-dose or low-dose cisplatin concurrent with radiotherapy in locally advanced head and neck squamous cell cancer
AU - Chang, Chia Lun
AU - Yuan, Kevin Sheng Po
AU - Wu, Szu Yuan
PY - 2017/7
Y1 - 2017/7
N2 - Background: No randomized studies have compared low-dose or high-dose concurrent chemoradiotherapy (CRT). Methods: In this study, 7219 patients with stage III or IV head and neck squamous cell carcinoma (HNSCC) were enrolled and categorized into 2 groups: group 1, comprising those undergoing low-dose concurrent CRT (n = 1575), and group 2, comprising those receiving high-dose concurrent CRT (n = 5644). Results: Cox regression analyses revealed that age ≥65 years, male, high Charlson comorbidity index (CCI) scores, radiotherapy (RT) duration ≥7.5 weeks, clinical stage IV cancer, oral cavity cancers, tobacco smoking, and total cisplatin dose ≥240 mg/m2 were significant independent prognostic risk factors for overall survival (OS). After adjustment for confounders, the adjusted hazard ratio (aHR; 95% confidence interval [CI]) for overall mortality was 0.83 (0.78-0.89; P < .001) in patients with oral cavity HNSCC undergoing high-dose concurrent CRT and 0.82 (0.77-0.94; P < .001) in patients with nonoral cavity HNSCC receiving high-dose concurrent CRT. Conclusion: High-dose concurrent CRT can reduce the incidence of death in patients with stage III or IV HNSCC.
AB - Background: No randomized studies have compared low-dose or high-dose concurrent chemoradiotherapy (CRT). Methods: In this study, 7219 patients with stage III or IV head and neck squamous cell carcinoma (HNSCC) were enrolled and categorized into 2 groups: group 1, comprising those undergoing low-dose concurrent CRT (n = 1575), and group 2, comprising those receiving high-dose concurrent CRT (n = 5644). Results: Cox regression analyses revealed that age ≥65 years, male, high Charlson comorbidity index (CCI) scores, radiotherapy (RT) duration ≥7.5 weeks, clinical stage IV cancer, oral cavity cancers, tobacco smoking, and total cisplatin dose ≥240 mg/m2 were significant independent prognostic risk factors for overall survival (OS). After adjustment for confounders, the adjusted hazard ratio (aHR; 95% confidence interval [CI]) for overall mortality was 0.83 (0.78-0.89; P < .001) in patients with oral cavity HNSCC undergoing high-dose concurrent CRT and 0.82 (0.77-0.94; P < .001) in patients with nonoral cavity HNSCC receiving high-dose concurrent CRT. Conclusion: High-dose concurrent CRT can reduce the incidence of death in patients with stage III or IV HNSCC.
KW - Concurrent chemoradiotherapy (CRT)
KW - Head and neck cancer
KW - High dose
KW - Low dose
KW - Prognostic factors
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U2 - 10.1002/hed.24763
DO - 10.1002/hed.24763
M3 - Article
C2 - 28370614
AN - SCOPUS:85017169938
SN - 1043-3074
VL - 39
SP - 1364
EP - 1370
JO - Head and Neck Surgery
JF - Head and Neck Surgery
IS - 7
ER -