Weekly versus every three weeks cisplatin as concurrent chemoradiotherapy in locally advanced head and neck cancer: single institution experience

Background: In locally advanced head and neck squamous cell carcinoma, 
chemo-radiation with cisplatin 100 mg/m2 administered once every three weeks 
is the standard of treatment. Because of its presumed reduced toxicity and 
convenience, low-dose weekly cisplatin is increasingly being replaced. There is, 
however, no level 1 proof of effectiveness equivalent to cisplatin / 3weeks.
Patient and methods: This is a retrospective comparative analysis. We 
compare the response, side effect and survival functions of cisplatin in low dose 
and high dose with concurrent radiotherapy in locally advanced head and neck 
carcinoma.
Results: In our study, there's no statistically difference between the two groups 
as regard the patients and tumor criteria. As regarding the side effect was 
tolerated but statistically significant difference in hematological toxicities 
anemia and leucopenia (p= 0.029, 0.001) between both groups and dysphagia 
(p= 0.054). There's no significant difference in response and 3-year local control 
in both groups. The 3-year overall survival was better in the 3-weekly dose 
schedule than the low weekly dose with significant difference.
Conclusion: No significant differences between both treatment groups 
regarding response rates, loco-regional free survival and most of treatment 
toxicities. So, the weekly dose can be a good substitution to the three-weekly 
dose with accepted toxicities, ease of administration and adequate cumulative 
total dose.