Comparative analysis of cisplatin tolerability in head and neck, bladder, and cervical cancers: Does the primary tumor site influence toxicity profiles

Aim: This study aims to investigate whether there is a difference in the tolerance of the cisplatin-radiotherapy regimen between head and neck cancers and bladder/cervical cancers. This will help determine if the typical tolerability issues associated with the cisplatin-radiotherapy combination are the primary barrier to delivering the desired cisplatin dose, or if the sensitive anatomical location of head and neck cancers leads to even poorer tolerance compared to other tumor sites. Method: Our study included 60 patients who received cisplatin and radiotherapy between 2017 and 2025. Of these, 34 had head and neck cancer, 21 had cervical cancer, and 5 had bladder cancer. We examined whether there was a difference in the patients' ability to receive the planned cisplatin dose. Results: The results showed that the proportion of head and neck cancer patients who were unable to complete the full treatment regimen was statistically significantly lower compared to the cervical and bladder cancer groups. The most common toxicity that hindered treatment in head and neck cancer was mucositis, while in the other groups it was nephrotoxicity. Among the head and neck cancer patients, 9 out of 17 were able to receive alternative therapies, with 7 receiving carboplatin and 2 receiving cetuximab. In the other group, 6 patients who did not receive treatment also could not access alternative therapies. Conclusions: The results of our study indicate that the poor tolerability of cisplatin in head and neck cancers can be attributed to the high prevalence of site-specific mucositis, which hinders its administration. Consequently, we believe the promotion of alternative clinical trials, particularly those evaluating carboplatin, is warranted for this patient population.