Any day, split halfway: Flexibility in scheduling high-dose cisplatin - A large retrospective review from a high-volume cancer center Journal Article


Authors: Kang, J. J.; Tchekmedyian, V.; Mohammed, N.; Rybkin, A.; Kitpanit, S.; Fan, M.; Wang, H.; Lobaugh, S. M.; Zhang, Z.; Lee, A.; Chen, L.; Yu, Y.; Zakeri, K.; Gelblum, D. Y.; Riaz, N.; McBride, S. M.; Tsai, C. J.; Cohen, M. A.; Cracchiolo, J. R.; Morris, L. G.; Singh, B.; Patel, S.; Ganly, I.; Boyle, J. O.; Wong, R. J.; Eng, J.; Zhi, W. I.; Ng, K.; Ho, A. L.; Dunn, L. A.; Michel, L.; Fetten, J. V.; Pfister, D. G.; Lee, N. Y.; Sherman, E. J.
Article Title: Any day, split halfway: Flexibility in scheduling high-dose cisplatin - A large retrospective review from a high-volume cancer center
Abstract: High-dose (HD) cisplatin remains the standard of care with chemoradiation for locally advanced oropharyngeal cancer (OPC). Cooperative group trials mandate bolus-HD (100 mg/m2 × 1 day, every 3 weeks) cisplatin administration at the beginning of the week to optimize radiosensitization—a requirement which may be unnecessary. This analysis evaluates the impact of chemotherapy administration day of week (DOW) on outcomes. We also report our institutional experience with an alternate dosing schedule, split-HD (50 mg/m2 × 2 days, every 3 weeks). We retrospectively reviewed 435 definitive chemoradiation OPC patients from 10 December 2001 to 23 December 2014. Those receiving non-HD cisplatin regimens or induction chemotherapy were excluded. Data collected included DOW, dosing schedule (bolus-HD vs split-HD), smoking, total cumulative dose (TCD), stage, Karnofsky Performance Status, human papillomavirus status and creatinine (baseline, peak and posttreatment baseline). Local failure (LF), regional failure (RF), locoregional failure (LRF), distant metastasis (DM), any failure (AF, either LRF or DM) and overall survival (OS) were calculated from radiation therapy start. Median follow-up was 8.0 years (1.8 months-17.0 years). DOW, dosing schedule and TCD were not associated with any outcomes in univariable or multivariable regression models. There was no statistically significant difference in creatinine or association with TCD in split-HD vs bolus-HD. There was no statistically significant association between DOW and outcomes, suggesting that cisplatin could be administered any day. Split-HD had no observed differences in outcomes, renal toxicity or TCD compared to bolus-HD cisplatin. Our data suggest that there is some flexibility of when and how to give HD cisplatin compared to clinical trial mandates. © 2021 UICC
Journal Title: International Journal of Cancer
Volume: 149
Issue: 1
ISSN: 0020-7136
Publisher: John Wiley & Sons  
Date Published: 2021-07-01
Start Page: 139
End Page: 148
Language: English
DOI: 10.1002/ijc.33518
PUBMED: 33586179
PROVIDER: scopus
DOI/URL:
Notes: Article -- Export Date: 1 June 2021 -- Source: Scopus
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Citation Impact
MSK Authors
  1. Zhigang Zhang
    317 Zhang
  2. Daphna Y Gelblum
    128 Gelblum
  3. Jay O Boyle
    118 Boyle
  4. Kenneth K Ng
    46 Ng
  5. Bhuvanesh Singh
    224 Singh
  6. Snehal G Patel
    336 Patel
  7. Loren Michel
    33 Michel
  8. Eric J Sherman
    234 Sherman
  9. Nadeem Riaz
    310 Riaz
  10. Nancy Y. Lee
    688 Lee
  11. David G Pfister
    317 Pfister
  12. Richard J Wong
    285 Wong
  13. Luc Morris
    182 Morris
  14. Alan Loh Ho
    145 Ho
  15. Ian Ganly
    309 Ganly
  16. Juliana Wai Ming Eng
    27 Eng
  17. Sean Matthew McBride
    197 McBride
  18. Lara   Dunn
    80 Dunn
  19. Chiaojung Jillian   Tsai
    181 Tsai
  20. Alisa   Rybkin
    5 Rybkin
  21. Marc A Cohen
    56 Cohen
  22. Anna Lee
    43 Lee
  23. Wanqing Iris Zhi
    24 Zhi
  24. Yao Yu
    40 Yu
  25. Jung Yun Kang
    30 Kang
  26. Linda Chang Chen
    26 Chen
  27. James Vincent Fetten
    14 Fetten
  28. Stephanie Marie Lobaugh
    24 Lobaugh
  29. Kaveh Zakeri
    22 Zakeri
  30. Ming Fan
    11 Fan
  31. Huili Wang
    10 Wang