Background: Concurrent chemoradiotherapy (CRT) with cisplatin is a widely accepted treatment strategy for patients with LA HNSCC. However, some patients are deemed Cisplatin ineligible for a variety of reasons and offered alternative sensitising agents. There is a paucity of data regarding outcomes in patients treated with non-cisplatin chemotherapy.
Patients and methods: We retrospectively analysed all consecutive adult LA HNSCC patients from January 2016 - Feb 2020 treated with chemoradiotherapy in the definitive or adjuvant settings. We collected data on patient and tumour characteristics, chemotherapy regimen, toxicity as well as clinical outcomes including locoregional control and survival.
Results: Over the 4-year period, a total of 194 patients received CRT for LA HNSCC. Median age was 61 years (range: 22 – 82) with a male/female ratio of 6:1. Primary tumour site was the oropharynx in 161 (83%), hypopharynx in 12 (6%), oral cavity in 11 (6%) and larynx in 9 (5%) patients. P16 positive tumours accounted for 146 (75%) of all tumours. Most patients (174, 90%) had definitive treatment as opposed to adjuvant therapy (20, 10%). Cisplatin based chemotherapy was employed in 154 (80%) of all patients, and non-cisplatin based treatment in 44 (20%). Carboplatin plus paclitaxel was used in 21 (11%) and Cetuximab in 15 (8%) of the entire patient cohort. Carboplatin alone in the adjuvant setting was used in 3 (1%) patients. Final survival and toxicity data will be reported at the conference.
Conclusion: Non-cisplatin based chemotherapy was used in 20% of our patient cohort with LA HNSCC. It is important to ascertain the safety and efficacy data in these two groups of patients treated with radical CRT.