Marilia Berlofa Visacri
State University of Campinas, Campinas – Sao Paulo – Brazil
Title: Toxicities and treatment response related to cisplatin chemotherapy and radiotherapy treatment in patients with advanced head and neck cancer: influence of different cisplatin doses.
Biography
Biography: Marilia Berlofa Visacri
Abstract
The most common treatment for patients with advanced head and neck cancer is chemotherapy with high doses of cisplatin and concomitant radiotherapy. The aim of this study was to determine the impact of cisplatin doses on toxicities and response to therapy in advanced head and neck cancer patients. It was an observational and prospective study at a hospital in Brazil where head and neck squamous cell carcinoma (stages III-IV) patients who received chemoradiation (80 or 100 mg/m2 of cisplatin per cycle) and completed 3 cycles were included. Two groups were studied considering the accumulated dose: G1 (280-300 mg/m2) and G2 (240-260 mg/m2). Audiometry was performed to evaluate ototoxicity and creatinine clearance to nephrotoxicity; severities were classified by CTCAE (v.4). Computed tomography and RECIST 1.1 were realized for treatment response. Forty patients were studied (G1: n=23; G2: n=17). There was a prevalence of male (90.0%), white (92.5%), Karnofsky Performance Scale 90-100% (63.2%) and had pharyngeal tumor (67.5%) in stage IV (85.0%), with a mean age of 52.9±7.5 years. Ototoxicity was present in 69.4% in G1 and 94.1% in G2, with a prevalence of grade 3 for both. In G1, 39.1% had nephrotoxicity versus 47.1% in G2, mostly grade 1. A complete response to treatment was observed in 8.7% in G1 and 3.5% in G2. For all outcomes there was no statistically significant difference between groups. In conclusion, the cisplatin doses had no statically significant impact on studied outcomes, however, a prevalence of complete response and toxicity was observed in G2.