Oropharynx cancer: carboplatin vs cisplatin-based chemoradiation in early disease

  • Oral Oncol
  • 2 Aug 2019

  • curated by Brian Richardson, PhD
  • Univadis Clinical Summaries
Access to the full content of this site is available only to registered healthcare professionals. Access to the full content of this site is available only to registered healthcare professionals.

Takeaway

  • Triweekly carboplatin is associated with similar effectiveness and better safety than high-dose cisplatin in patients receiving chemoradiation for stage I/II human papillomavirus (HPV)-associated oropharyngeal squamous cell carcinoma (OPSCC).

Why this matters

  • Triweekly carboplatin may represent a safer treatment option for patients with early-stage disease.

Key results

  • In stage I/II disease, high-dose cisplatin and triweekly carboplatin were associated with similar locoregional recurrence (LR), distant metastasis (DM), overall recurrence (OR), OS, and cause-specific survival (CSS; all P>.05).
  • In stage III disease, high-dose cisplatin was associated with lower rates of LR (9% vs 21%; HR, 0.22; P=.03), DM (7% vs 28%; HR, 0.15; P=.006), and OR (14% vs 40%; HR, 0.20; P=.002).
    • Cisplatin was superior to carboplatin for OS (89% vs 78%; HR, 0.34; P=.04) and CSS (95% vs 80%; HR, 0.18; P=.02).
  • Carboplatin was associated with lower rates of grade 3 leukopenia (11.0% vs 24.8%; P<.001 weight loss from baseline vs p gastrostomy-tube placement and emergency department visit within days of treatment>

Study design

  • 421 with HPV-associated OPSCC: 230 treated with high-dose cisplatin and 191 with triweekly carboplatin, were included.
  • Funding: Kaiser Permanente Regional Research Committee.

Limitations

  • Retrospective study.