Original Article Feasibility Study of Single Agent Cisplatin and Concurrent Radiotherapy in Japanese Patients with Squamous Cell Carcinoma of the Head and Neck: Preliminary Results

Background: Concurrent chemoradiotherapy with the single agent cisplatin (CDDP þ RT) has been recognized worldwide as the standard treatment for unresectable locally advanced SCCHN. The objective of this study was to clarify the feasibility of CDDP þ RT in Japanese patients. Patients and methods: Patients with unresectable squamous cell carcinoma of the head and neck were given single daily fractionated radiation (70 Gy at 2 Gy/day) and chemotherapy consisting of a 2 h infusion of CDDP 100 mg/m2 on days 1, 22 and 43. The primary endpoint was the rate of completion of CDDP þ RT. Results: Between November 2005 and January 2007, 20 patients were enrolled, 19 males and one female with a median age of 61.5 years (range 50–74). One patient had recurrent unresectable disease after surgery and the remaining 19 had stage IV disease. No grade 4 hematologic toxicities were observed. The incidence of grade 3 mucositis was 55 % and no treatment-related death occurred. Full-dose irradiation was performed in all patients, with a median duration of radiotherapy of 50 days (range 48–54). Although all patients received the first two administrations of CDDP, the third dose was administed in 17 patients (85%). The rate of completion of CDDP þ RT was 85 % and the dose intensity of CDDP was 28.9 mg/m2/ week (relative dose intensity 89%). Overall complete response rate was 50 % and the rate of primary complete response was 90%. Conclusion: Concurrent chemoradiation therapy with the standard dose of CDDP is feasible in Japanese patients. Treatment modification based on racial differences is not necessary. Key words: cisplatin – squamous cell carcinoma – head and neck – chemoradiotherapy – racial differenc