A comparison of weekly versus 3-weekly cisplatin during adjuvant radiotherapy for high-risk head and neck cancer

Patients with head and neck squamous cell carcinoma (HNSCC) treated with primary surgery have a very high risk of recurrence if resection margins are positive and/or if there is extra-capsular extension of lymph node metastases. Combined analysis of two phase 3 studies demonstrated that these patients derive benefit from adding high dose cisplatin (100mg/m2 at day 1, day 22 and day 43) to adjuvant radiotherapy with regard to loco-regional control, disease free and overall survival [1–3]. The combination of adjuvant radiotherapy and high dose cisplatin induces significant acute and long term toxicity, and even in a trial setting only 61% and 64% of the patients could complete 3 cycles of chemotherapy [1,2].

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