Comparison of weekly and triweekly cisplatin regimens during concurrent chemoradiotherapy for nasopharyngeal carcinoma

BMC Cancer. 2019 May 22;19(1):482. doi: 10.1186/s12885-019-5688-z.

Abstract

Background: We compared the survival outcomes and acute toxicities of weekly and triweekly cisplatin regimens during concurrent chemoradiotherapy (CCRT) in nasopharyngeal carcinoma (NPC) patients.

Methods: Patients were treated with CCRT alone. CCRT was initiated on the first day of RT. Cisplatin 30-40 mg/m2 was infused on days 1, 8, 15, 22, 29, 36 and 43 in the Weekly Group, while cisplatin 80-100 mg/m2 was delivered on days 1, 22 and 43 in the Triweekly Group. The survival outcomes were revealed by the Kaplan-Meier method and Cox regression modelling to measure 5-year overall survival (OS), disease-free survival (DFS), locoregional relapse-free survival (LRFS) and distant metastasis-free survival (DMFS).

Results: Ninety-three (28.9%) patients received three to 7 cycles of cisplatin weekly (Weekly Group) and 229 (71.1%) patients received two to 3 cycles of cisplatin triweekly (Triweekly Group). Five-year OS (weekly vs. triweekly, 96.7% vs. 88.3%, P = 0.036) and DFS (weekly vs. triweekly, 90.7% vs. 80.5%, P = 0.028) were better in the Weekly Group than in the Triweekly Group. The weekly vs. triweekly 5-year DMFS and LRFS rates were: DMFS, 96.7% vs. 91.4%, χ2 = 2.694, P = 0.101; LRFS, 96.3% vs. 93.5%, χ2 = 1.317, P = 0.251. Cisplatin delivery regimen was not an independent prognostic factor. The incidence rate of acute toxicities was similar between the groups.

Conclusions: Compared with Triweekly cisplatin regimen, Weekly regimen may be a better choice during CCRT.

Keywords: Cisplatin; Concurrent chemoradiotherapy; Nasopharyngeal carcinoma; Survival.

Publication types

  • Comparative Study

MeSH terms

  • Adult
  • Antineoplastic Agents / administration & dosage*
  • Antineoplastic Agents / adverse effects
  • Chemoradiotherapy / adverse effects
  • Chemoradiotherapy / methods*
  • Cisplatin / administration & dosage*
  • Cisplatin / adverse effects
  • Drug Administration Schedule
  • Female
  • Humans
  • Kaplan-Meier Estimate
  • Male
  • Middle Aged
  • Nasopharyngeal Carcinoma / therapy*
  • Nasopharyngeal Neoplasms / therapy*
  • Retrospective Studies
  • Treatment Outcome

Substances

  • Antineoplastic Agents
  • Cisplatin