Head/neck cancer: carboplatin and cisplatin-based CRT offer similar survival

  • Xiang M & al.
  • J Natl Compr Canc Netw
  • 1 Sep 2019

  • curated by Brian Richardson, PhD
  • Univadis Clinical Summaries
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Takeaway

  • Definitive carboplatin-based chemoradiotherapy (CRT) is associated with similar survival outcomes as cisplatin-based CRT in patients with locoregionally advanced head and neck squamous cell carcinoma (HNSCC).
  • Both approaches were superior to RT alone or RT with concurrent cetuximab,

Why this matters

  • Although cisplatin is preferred, carboplatin is associated with lower toxicity and may represent an effective alternative for certain populations, such as the elderly.

Key results

  • Carboplatin- and cisplatin-based CRT were associated with similar 3-year cancer-specific mortality (CSM; 29% vs 26% [P=.19]; HR, 1.01 [P=.94] in multivariate analysis), as well as other-cause mortality (P=.76) and OS (P=.35) in matched analysis.
  • Both carboplatin- and cisplatin-based CRT were associated with superior CSM compared with RT alone (P=.02 and P<.0001 respectively and rt with concurrent cetuximab p>
  • Patients who received cisplatin were more likely to experience acute renal failure (P=.04), although patients who received carboplatin had more neutropenia (P=.03) and pneumonia (P=.01).

Study design

  • 1149 patients with locoregionally advanced (stage III-IVB) HNSCC, 807 who received cisplatin-based CRT and 342 who received carboplatin-based CRT, were analyzed for survival/mortality outcomes.
  • Funding: Zanello Family Foundation; Stanford Head and Neck Surgery Research Fund.

Limitations

  • Retrospective design.