Concurrent Weekly Cisplatin and Simultaneous Integrated Boost-IMRT in Locally Advanced Head and Neck Squamous Cell...

Area of Science:

• Oncology
• Radiation Oncology
• Head and Neck Cancer

Background:

• Concurrent chemoradiation with weekly cisplatin is a standard treatment for locally advanced head and neck squamous cell carcinoma (LA-HNSCC).
• Simultaneous integrated boost intensity-modulated radiotherapy (SIB-IMRT) allows for single-phase IMRT delivery with improved dose distribution.

Purpose of the Study:

• To evaluate the treatment compliance, toxicities, and clinical outcomes of LA-HNSCC patients treated with concurrent weekly cisplatin and SIB-IMRT.

Main Methods:

• Retrospective evaluation of 150 LA-HNSCC patients treated between April 2015 and December 2019.
• All patients received 70Gy in 33-35 fractions via SIB-IMRT with concurrent weekly cisplatin (40 mg/m²).
• Assessment of treatment compliance, toxicities, overall survival (OS) using Kaplan-Meier estimates, and prognostic factor analysis.

Main Results:

• Median age was 58.5 years; 45% had oropharyngeal cancer, 62% T3, 41% N2, and 51% Stage IV disease.
• 84.7% received the planned cumulative chemotherapy dose (200 mg/m²).
• Common toxicities included Grade 2 xerostomia (79%), Grade 3 neutropenia (11%), mucositis (15%), and pharyngitis (21%). Complete response rate was 66.6%. Median OS was 33.2 months, with a 60% OS at median follow-up of 21.4 months.

Conclusions:

• Definitive chemoradiation with weekly cisplatin and SIB-IMRT is a well-tolerated treatment option for LA-HNSCC.
• This approach demonstrates favorable clinical outcomes, supporting its use in LA-HNSCC management.