頭頸部癌における高用量シスプラチン併用化学放射線療法のシスプラチン総投与量に関連する因子の検討

抄録

Concurrent chemoradiotherapy (CRT) is one of the standard treatment strategies for patients with locally advanced head and neck squamous cell carcinoma (HNSCC). While high-dose cisplatin (CDDP) administered every 3 weeks is the most commonly used chemotherapy regimen for these patients, this regimen can often not be successfully completed in all patients due to the occurrence of severe adverse events. In the present study, we conducted a retrospective review of the data of HNSCC patients treated with high-dose CDDP-CRT and examined the factors that affected the rate of successful completion of CDDP treatment.

Between 2012 to 2019, a total of 122 patients were enrolled for in this retrospective analysis. We defined CDDP completion as successful administration of a cumulative dose of ≥200 mg/m², and CDDP full dose as 300 mg/m². The associations of various clinical factors, such as the gender, age, year of treatment, primary tumor site, body mass index (BMI), pretreatment laboratory data (serum CRP, serum albumin, creatine clearance), and percent body weight loss during the treatment period with the rates of CDDP completion and rate of full dose administration were analyzed.

The cumulative CDDP dose was ≥200 mg/m² (CDDP completion) in a total of 96 (79%) patients, and 300 mg/m² (full dose) in 38 (31%) patients. While univariate analyses identified pretreatment serum albumin, year of treatment, and percent body weight loss during the treatment period as factors that significantly affected the CDDP completion rate (CDDP dose ≥200 mg/m²), age (70 years old and over), pretreatment BMI (over 25), and percent body weight loss were the only factors identified by multivariate analysis as showing independent statistically significant association.

The present findings suggest that pretreatment parameters, especially the age, BMI, and weight loss during CRT significantly influence the high-dose CDDP completion rate during CRT with high-dose CDDP.