The Cisplatin Total Dose and Concomitant Radiation in Locoregionally Advanced Head and Neck Cancer: Any Recent Evidence for Dose Efficacy?

作者: Lindsay Carlsson , Scott V. Bratman , Lillian L. Siu , Anna Spreafico

DOI: 10.1007/S11864-017-0482-0

关键词: CisplatinInternal medicineOncologyRegimenSurgerySystematic reviewChemoradiotherapyConcomitantHead and neck cancerRadiation therapyClinical trialMedicine

摘要: Concurrent chemoradiotherapy (CRT) with high-dose (100 mg/m2), single-agent cisplatin is considered the standard of care for locoregionally advanced head and neck cancer (LAHNC). Poor compliance often due to significant treatment-related toxicities observed during CRT regimen has stimulated research efforts examine evidence optimal cumulative dose schedule. The findings from this systematic literature review demonstrate that there are insufficient prospective, randomized controlled data determine total (and schedule) administer concomitantly radiotherapy in treatment LAHNC. Given clinical challenges associated administering concurrent cisplatin, as well long-term accompanying treatment, an examination available efficacy continued interest. Moving forward, it critical researchers include complete descriptions key disease variables (i.e. HPV status) inform strengthen decisions. substantial heterogeneity LAHNC led focus recent risk-stratify using a combination molecular markers (e.g. status). Thus, may need be modified reflect specific characteristics individual patient subpopulations being treated. At present, remains LAHNC, but field rapidly evolving. National international trials ongoing evaluate de-intensification favourable risk subsets intensification poor-risk subsets, these will provide evidence-based guidance individualize therapy ultimate goal improving outcomes.

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