Altered fractionation radiotherapy combined with concurrent low-dose or high-dose cisplatin in head and neck cancer: A systematic review of literature and meta-analysis

Result code in IS VaVaI

<a href="https://www.isvavai.cz/riv?ss=detail&h=RIV%2F65269705%3A_____%2F18%3A00070343" target="_blank" >RIV/65269705:_____/18:00070343 - isvavai.cz</a>

Alternative codes found

RIV/00216224:14110/18:00103957

Result on the web

<a href="http://dx.doi.org/10.1016/j.oraloncology.2017.11.025" target="_blank" >http://dx.doi.org/10.1016/j.oraloncology.2017.11.025</a>

DOI - Digital Object Identifier

<a href="http://dx.doi.org/10.1016/j.oraloncology.2017.11.025" target="_blank" >10.1016/j.oraloncology.2017.11.025</a>

Result language

angličtina

Original language name

Altered fractionation radiotherapy combined with concurrent low-dose or high-dose cisplatin in head and neck cancer: A systematic review of literature and meta-analysis

Original language description

Objectives: Altered fractionation radiotherapy and concomitant chemoradiotherapy represent commonly used intensification strategies in the management of locally advanced squamous cell carcinoma of the head and neck (LA-SCCHN). This meta-analysis compares compliance, safety, and efficacy between two single-agent cisplatin schedules given concurrently with altered fractionation radiotherapy. Methods: We systematically searched for prospective trials of patients with LA-SCCHN who received post-operative or definitive altered fractionation concurrent chemoradiotherapy. High-dose cisplatin once every three to four weeks (100 mg/m(2), 2 doses) was compared with a weekly low-dose protocol (&lt;= 50 mg/m2, &gt;= 4 doses). The primary outcome was overall survival. The secondary endpoints comprised treatment adherence, acute and late toxicities, and objective response rate. Results: Twelve studies with 1373 patients treated with definitive chemoradiotherapy were included. Compared to the weekly low-dose cisplatin regimen, the three-to four-weekly high-dose cisplatin regimen improved overall survival (p = .0185), was more compliant with respect to receiving all planned cycles of cisplatin (71% versus 95%, p = .0353), and demonstrated less complications in terms of severe (grade 3-4) acute mucositis and/or stomatitis (75% versus 40%, p =. 0202) and constipation (8% versus 1%, p = .0066), toxic deaths (4%, versus 1%, p = .0168), 30-day mortality (8% versus 3%, p = .0154), and severe late subcutaneous fibrosis (21% versus 2%, p &lt; .0001). Overall and complete response rates were similar between both chemotherapy schedules. Conclusion: In chemoradiotherapy incorporating altered fractionation, two cycles of high-dose cisplatin with a three to four week interval are superior to weekly low-dose schedules. Further studies should identify those who might derive the greatest benefit from this intensified approach.

Czech name

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Czech description

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Type

J_imp - Article in a specialist periodical, which is included in the Web of Science database

CEP classification

—

OECD FORD branch

30204 - Oncology

Project

—

Continuities

I - Institucionalni podpora na dlouhodoby koncepcni rozvoj vyzkumne organizace

Publication year

2018

Confidentiality

S - Úplné a pravdivé údaje o projektu nepodléhají ochraně podle zvláštních právních předpisů

Name of the periodical

Oral oncology

ISSN

1368-8375

e-ISSN

—

Volume of the periodical

76

Issue of the periodical within the volume

JAN 2018

Country of publishing house

NL - THE KINGDOM OF THE NETHERLANDS

Number of pages

9

Pages from-to

52-60

UT code for WoS article

000418885000008

EID of the result in the Scopus database

2-s2.0-85037627766