Low Dose Daily Cisplatin vs Weekly Dose Cisplatin in Radiation Therapy for Head and Neck Squamous Cell Carcinoma, A Comparative Study

Authors

Sharath Sreeni Department of Radiation Oncology, Assam Medical College and Hospital, Dibrugarh, Assam, India.
Kankan Jyoti Deka Department of Radiation Oncology, Assam Medical College and Hospital, Dibrugarh, Assam, India.
Trishan Paul Department of Radiation Oncology, Assam Medical College and Hospital, Dibrugarh, Assam, India.
Ayesha Agarwal Department of Clinical Oncology, Tinsukia Medical College, Tinsukia, Assam, India.
Partha Pratim Patowary Department of Radiation Oncology, SCI, Guwahati, Assam, India.
Debasis Borah Department of Radiation Oncology, Assam Medical College and Hospital, Dibrugarh, Assam, India.
Chiranjiv Baruah Department of Clinical Oncology, Nalbari Medical College, Nalbari, Assam, India.

Keywords:

Head and neck cancer, Low dose Cisplatin, Radiation therapy.

Abstract

Introduction: Head and neck cancer is prevalent in India’s North and North Eastern regions, often treated with concurrent cisplatin-based chemo-radiation therapy. This study compares the efficacy, side effects, and toxicities of daily low-dose cisplatin versus weekly high-dose cisplatin in head and neck cancer patients receiving radiation therapy. Objective: To assess the efficacy and compare the toxicities of daily versus weekly cisplatin dosing in concurrent chemo-radiation therapy.

Materials and Methods: A study of 139 patients with biopsy-proven head and neck squamous cell carcinoma was conducted at Assam Medical College from October 2022 to August 2024. Patients were assigned to either daily (ARM A) or weekly (ARM B) cisplatin regimens. Toxicities were graded using RTOG criteria, and tumour response was assessed with RECIST criteria.

Results: ARM A showed a higher complete response (56%) compared to ARM B (49%). ARM A had lower acute toxicities, including dysphagia and mucositis( p value < 0.05). Both regimens showed similar weight loss and low rates of nephrotoxicity.

Conclusion: Daily low-dose cisplatin offers similar efficacy with fewer severe acute toxicities, making it a preferable option for head and neck cancer patients.