Efficacy and safety of definitive low-dose weekly cisplatin with concurrent radiotherapy for locally advanced head and neck squamous cell carcinoma.

Objective: Low-dose weekly cisplatin with concurrent radiotherapy (wCRT) is considered a potential alternative to the current standard of high-dose three-weekly cisplatin with concurrent RT (twCRT) for the treatment of locally advanced head and neck squamous cell carcinoma (LA-HNSCC) owing to its reduced toxicity. This study aimed to investigate the efficacy and safety of wCRT for LA-HNSCC treatment.

Methods: This retrospective analysis included patients with stage III or IV LA-HNSCC who underwent definitive wCRT as the first-line treatment between January 2007 and December 2021. Patients with distant metastases or p16-positive oropharyngeal cancer or who had undergone induction chemotherapy were excluded.

Results: Seventy-eight eligible patients were identified, 32 of whom were aged ≥70 years. The 2- and 5-year overall survival (OS) rates were 81.0% and 63.5%, respectively, with a complete response rate of 89.7%. A cumulative cisplatin dose of ≥200 mg/m² was administered to 88.5% of the patients and found to be a significant prognostic factor for OS in both univariate and multivariate analyses. Acute adverse events were generally manageable, with fewer non-haematological toxicities, likely owing to multidisciplinary supportive care.

Conclusions: Although twCRT remains the standard, wCRT appears a viable and less toxic alternative for treating LA-HNSCC.