Table 2.
Toxicity of different primary and adjuvant radiochemotherapy regimens for locally advanced head and neck tumors
| Study | Patients (n) | Primary/adjuvant RCT | RT-dose (Gy) | Cisplatin regime | Full CT applied | Full RT dose applied | Acute toxicity III/IV (%) | Chronic toxicity III/IV (%) |
|---|---|---|---|---|---|---|---|---|
| Present study | 50 | RCT and S + RCT |
70 64 |
6 mg/m2 on every day of RT | 90% of patients received more than 80% of planned dose | 94% | Mucositis/dysphagia 22%; Hematologic 14%; Mucositis + Dysphagia + Hematologic 8% |
Xerostomia 6%; Cutaneous fibrosis 4%; Lymphedema 4% Lymphedema + fibrosis 4% |
| Rades et al. (2008) | 61 | RCT and S + RCT |
60–72 | 100 mg/m2 on day 1, 22, 43 or |
52% | 87% | Hematologic 39% Nausea/vomiting 28% Mucositis 40% Skin 24% |
Xerostomia 7% Fibrosis 7% |
| 67 | RCT and S + RCT |
60–72 | 20 mg/m2 and 600 mg/m2 5-FU on days 1–5 and 29–33 | 90% | Not given | Hematologic 22% Nausea/vomiting 5% Mucositis 45% Skin 15% |
Xerostomia 10% Fibrosis 13% |
|
| Lau et al. (2006) | 57 | RCT | 70 | 20 mg/m2 during days 1–4 of weeks 1 and 5 | 62% | 100% | 63% | Not given |
| Castro et al. (2007) | 30 | RCT | 70 | 100 mg/m2 on day 1, 22, 43 | 50% | 83.3% | 87% | Not given |
| Adelstein et al. (2003) | 95 | RCT | 70 | 100 mg/m2 on day 1, 22, 43 | 85.1% | 85.1% | 85% | Not given |
| Bernier et al. (2004) | 167 | S + RCT | 66 | 100 mg/m2 on day 1, 22, 43 | 49%a | 96% with more than 60 Gy | 41% | Fibrosis 10%, Xerostomia 14%, Lymphedema 7%, Bone 1%, skin 1% |
| Cooper et al. (2004) | 206 | S + RCT | 66 | 100 mg/m2 on day 1, 22, 43 | 61% | 80% | 77% | Esophagus 15% Xerostomia 7%, bone 6%, skin 5%, renal 2% |
| Bauchaud et al. (1996) | 39 | S + RCT | 65–70 | 50 mg/m2 once per week | 82% of patients received more than 66% of planned dose | 100% | 41% | Fibrosis 10% Osteonecrosis 3% |
| Hoebers et al. (2007) | 47 | RCT | 70 | 6 mg/m2 daily for 20 shots | Mean no. of cisplatin shots: 17.3 | 96% | Mucositis 65% Hematologic 44% |
Fibosis 9% Osteradionecrosis 4% |
| Jeremic et al. (2004) | 106 | RCT | 70 | 6 mg/m2 on every day of RT | 92% | 92% | Stomatitis 13% Esophagitis 3% |
Xerostomia 6%, Fibrosis 3%, bone 2%, skin 2% |
RCT primary radiochemotherapy, S + RCT curative surgery and adjuvant radiochemotherapy
aThird cycle of chemotherapy could be administered on time without delay in 49% of patients