Chemoradiotherapy Focused on Cisplatin Dosage per Cycle for Elderly with Head and Neck Cancer

Objectives: This study aimed to investigate the impact of cisplatin-based chemoradiotherapy dosage per cycle on prognosis for elderly patients. Methods: This retrospective study included 90 patients with head and neck squamous cell carcinoma who received cisplatin - based chemoradiotherapy. Those who received triweekly cisplatin (100) regimen for definitive chemoradiotherapy and triweekly cisplatin (80) regimen for post-operative chemoradiotherapy were allocated to the high-dose group. Meanwhile, those who received triweekly cisplatin (80) regimen for definitive chemoradiotherapy and weekly cisplatin (40) regimen for postoperative chemoradiotherapy were allocated to the low-dose group. The outcomes in elderly and non-elderly patients following chemoradiotherapy were compared between the groups. Results: The patients in the high-dose group had a significantly higher incidence of severe toxicity than that in low-the groups (P < 0.05), and the elderly patients in the high-dose group demonstrated high rate of severe toxicity (34.8%) compared to that in the low-dose group (10.9%). Furthermore, only in the elderly patients, overall survival was significantly reduced in the high-dose group than that in the low-dose group (P < 0.05). In elderly patients, the total dosage of cisplatin administered to those who developed severe toxicity was significantly lower than that for patients who did not experience toxicity (P < 0.01). Furthermore, these patients demonstrated significantly short overall survival (P < 1.0×10-5). Conclusions: Current cisplatin dosage per cycle may exhibit excessive for elderly patients.