Real-life data on the use of three-weekly versus weekly cisplatin concomitant with radiotherapy in the locoregional treatment of patients with head and neck squamous cell carcinoma

INTRODUCTION: The choice of cisplatin regimen concomitant with radiotherapy (CRT) has been a matter of debate in recent years. In the adjuvant setting, the phase III JCOG 1008 trial has demonstrated non-inferiority of the weekly dose (qW) regimen in terms of overall survival. In the radical setting, the phase III ConCERT trial did the same in terms of 2-year local control rate. However, data from the 6-year results of the phase III clinical trial by Noronha et al. (adjuvant setting) and the meta-analysis conducted by Zhu, J. et al. (2012) (radical setting) positions the three-weekly (q3W) regimen as superior. MATERIAL AND METHODS: This was a retrospective, descriptive, comparative observational non-inferiority study (δ = 10%). We analyzed data from 58 patients with HNSCC treated with CRT (36 q3W, 22 qW; 44.8% adjuvant setting and 53.4% radical setting) between January 2019 and December 2023. Patients in the qW arm were less fit than those treated with q3W in our sample. RESULTS: We found no difference in median cumulative cisplatin dose or in G3 toxicity rate. With a median follow-up of 27 months (q3W) and 14 months (qW), the recurrence, progression, or exitus rate was 19.4%, 22.2%, and 25% (q3W) vs. 13.6%, 18.2%, and 18.2% (qW). No significant differences were found in the Kaplan-Meier survival estimates (long-rank test p: local/distant-DFS = 0.93; PFS = 0.91; OS = 0.71). CONCLUSIONS: Tolerability and compliance of the qW regimen in a less fit patient population was similar to that of the fitter q3W patients. No differences were found in DFS, PFS, and OS.