TURKISH JOURNAL OF ONCOLOGY 2008 , Vol 23 , Num 1
Cisplatin-based concomitant chemoradiotherapy in locally advanced squamous cell carcinoma of head and neck: toxicity and feasibility analysis
Beste Melek ATASOY, 1 Faysal DANE, 2 Murat SARI, 3 Züleyha AKGÜN, 1 Perran Fulden YUMUK, 2 Nazım Serdar TURHAL, 2 Ufuk ABACIOĞLU, 1 Meriç ŞENGÖZ4
1Marmara Üniversitesi Tıp Fakültesi, Radyasyon Onkolojisi Anabilim Dalı, İstanbul, Turkey
2Marmara Üniversitesi Tıp Fakültesi, İç Hastalıkları Anabilim Dalı Tıbbi Onkoloji Bilim Dalı, İstanbul, Turkey
3Marmara Üniversitesi Tıp Fakültesi, Kulak Burun Boğaz Hastalıkları Anabilim Dalı, İstanbul, Turkey
4Acıbadem Kozyatağı Hastanesi, Radyoterapi Kliniği, İstanbul, Turkey
OBJECTIVES
In this study, we assessed the side effects and the factors related to patients, disease and, treatment that might change the decision for concurrent chemoradiotherapy (CRT) in locally advanced head and neck cancer.

METHODS
A total of 65 patients (49 primary; 16 postoperative) who received curative radiotherapy (median 70 Gy) with conventional fractionation schedule were enrolled into the study. Concomitant cisplatin were administered either 60-80 mg/m2 every 3 weeks (n=57) or 40 mg/m2 weekly (n=8).

RESULTS
Concurrent chemotherapy was completed in 46.1% patients. Premature chemotherapy termination was done due to grade 3 adverse event (41.6%), patients’ refusal (19.4%) or physician decision (33.3%). Initial Karnofsky Performance Status (KPS) significantly predicted concurrent chemotherapy completeness (KPS ≥90, 63.8% vs KPS <90, 24.1%; p=0.001).

CONCLUSION
Despite the promising results, concurrent CRT requires careful consideration for toxicity. Initial performance status prior to CRT might be a predictor for unplanned chemotherapy stopping due to side effects. Keywords : Chemoradiotherapy; cisplatin; concurrent; head and neck cancer; side effect; squamous cell carcinoma