Do you give two or three cycles of cisplatin to patients with H&N squamous cell carcinoma receiving chemoradiation with Q3 week cisplatin?

The data from an old RTOG study show that a total of 2 cycles of cisplatin 100 mg/m2 concurrently with accelerated RT is as good as 3 cycles with standard RT. My experience is that most patients do not tolerate cycle 3 of high dose cisplatin and therefore, not given.

Personally, I do not routinely u...

Great question!

I prefer to use the weekly 40 mg/m2 cisplatin concurrently with XRT for HN cancer. It is more tolerable and total 280 mg/m2. We know that weekly cisplatin 30 mg/m2 (total 210 mg/m2) has inferior outcome compared to weekly cisplatin 40 mg/m2 for radiosensitizer.

If I have to give high...

I've asked experts at different centers and (as has been noted in their publications & editorials), the range of answers indicates a high anecdotal influence. It seems q 3 wk 100mg/m2 is preferable particularly for the HPV negative patients, but many of those patients (smoker/drinker) are frail & ar...

I will be using weekly 40/m2 CDDP which is well tolerated by most patients, and particularly now when the risk of hospital admission for febrile neutropenia or some other complication related to higher dose concomitant chemo/RT could lead to an entirely novel set of dangers for our patients. Please ...