Skip Navigation LinksHome > February 2014 - Volume 37 - Issue 1 > Dose Delivery Analysis of Weekly Versus 3-Weekly Cisplatin C...
American Journal of Clinical Oncology:
doi: 10.1097/COC.0b013e31826b9b1a
Original Articles: Head & Neck

Dose Delivery Analysis of Weekly Versus 3-Weekly Cisplatin Concurrent With Radiation Therapy for Locally Advanced Nasopharyngeal Carcinoma (NPC)

Jagdis, Amanda MD*; Laskin, Janessa MD; Hao, Desiree MD; Hay, John MB, BChir§; Wu, Jonn MD§; Ho, Cheryl MD, FRCPC

Collapse Box



The purpose of this study was to analyze the dose delivery and toxicity of weekly cisplatin versus high-dose cisplatin given every 3 weeks in a tertiary oncology clinic.


From January 2000 to July 2009, patients with biopsy-proven nasopharyngeal carcinoma receiving concurrent cisplatin with curative-intent radiation therapy (RT) were included. Before 2005, most patients received cisplatin (Q3) (100 mg/m2 intravenously days 1, 22, and 43 of RT) and 3-dimensional conformal RT (66 Gy, 33 fractions). After 2005, most patients received weekly cisplatin (Q1) (40 mg/m2 intravenously weekly for 7 wk of RT) and intensity-modulated radiotherapy (70 Gy, 35 fractions).


Seventy-three patients were analyzed: 45 for Q1 and 28 for Q3. Cumulative doses ≥200 mg/m2 were achieved in 80% of Q1 and 86% of Q3 patients, respectively. Dose reduction due to toxicity was required in 2/45 (4%) of Q1 patients compared with 11/28 (39%) of Q3 patients (P=0.0003). Toxicities in Q1 and Q3 patients included: hospitalization for acute toxicity in 20% and 35.7%; mean weight loss 10.85% and 8.75%; percutaneous endoscopic gastrostomy tube placement in 25.6% and 29.6%; and grade 3 dehydration in 11.1% and 17.9%, respectively. Median follow-up time was 3 years for Q1 and 6 years for Q3 patients. Median disease-free survival was 46 months for the Q1 group and 53 months for the Q3 group (P=0.667). There was no difference in overall survival between Q1 and Q3.


In this series, weekly 40 mg/m2 cisplatin and 3-weekly 100 mg/m2 cisplatin showed similar deliverability, toxicity profiles, and outcomes. At our center, weekly cisplatin is standard of care for patients with locally advanced nasopharyngeal carcinoma undergoing chemoradiotherapy.

Copyright © 2012 by Lippincott Williams & Wilkins


Article Tools


Search for Similar Articles
You may search for similar articles that contain these same keywords or you may modify the keyword list to augment your search.

Connect With Us


For additional oncology content, visit LWW Oncology Journals on Facebook.