Any day, split halfway: Flexibility in scheduling high‐dose cisplatin—A large retrospective review from a high‐volume cancer center
Year: 2021
Type: article
Study design: Observational Study
Abstract: High‐dose (HD) cisplatin remains the standard of care with chemoradiation for locally advanced oropharyngeal cancer (OPC). Cooperative group trials mandate bolus‐HD (100 mg/m2 × 1 day, every 3 weeks) cisplatin administration at the beginning of the week to optimize radiosensitization—a requirement which may be unnecessary. This analysis evaluates the impact of chemotherapy administration day of week (DOW) on outcomes. We also report our institutional experience with an alternate dosing schedule, split‐HD (50 mg/m2 × 2 days, every 3 weeks). We retrospectively reviewed 435 definitive chemoradiation OPC patients from 10 December 2001 to 23 December 2014. Those receiving non‐HD cisplatin regimens or induction chemotherapy were excluded. Data collected included DOW, dosing schedule (bolus‐HD vs split‐HD), smoking, total cumulative dose (TCD), stage, Karnofsky Performance Status, human papillomavirus status and creatinine (baseline, peak and posttreatment baseline). Local failure (LF), regional failure (RF), locoregional failure (LRF), distant metastasis (DM), any failure (AF, either LRF or DM) and overall survival (OS) were calculated from radiation therapy start. Median follow‐up was 8.0 years (1.8 months‐17.0 years). DOW, dosing schedule and TCD were not associated with any outcomes in univariable or multivariable regression models. There was no statistically significant difference in creatinine or association with TCD in split‐HD vs bolus‐HD. There was no statistically significant association between DOW and outcomes, suggesting that cisplatin could be administered any day. Split‐HD had no observed differences in outcomes, renal toxicity or TCD compared to bolus‐HD cisplatin. Our data suggest that there is some flexibility of when and how to give HD cisplatin compared to clinical trial mandates.
Source: International Journal of Cancer
DOI: 10.1002/ijc.33518
Authors: Jung Julie Kang, Vatche Tchekmedyian, Nader Mohammed, Alisa Rybkin, Sarin Kitpanit, Ming Fan, Huili Wang, Stephanie M. Lobaugh, Zhigang Zhang, Anna Lee, Linda Chen, Yao Yu, Kaveh Zakeri, Daphna Y. Gelblum, Nadeem Riaz, Sean M. McBride, C. Jillian Tsai, Marc A. Cohen, Jennifer R. Cracchiolo, Luc G. Morris, Bhuvanesh Singh, Snehal Patel, Ian Ganly, Jay O. Boyle, Richard J. Wong, Juliana Eng, Wanqing Iris Zhi, Kenneth Ng, Alan L. Ho, Lara A. Dunn, Loren Michel, James V. Fetten, David G. Pfister, Nancy Y. Lee, Eric J. Sherman
Institution: Memorial Sloan Kettering Cancer Center
Language: English
Topic: Head and Neck Cancer Studies
Subfield: Otorhinolaryngology
Field: Medicine
Domain: Health Sciences
Open Access status: green
Funder: National Cancer Institute
Award: Cancer Center Support Grant
OpenAlex ID: W3131893291