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Background <p>Despite considerable therapeutic advances, a&#xa0;significant evidence gap remains regarding optimal treatment strategies for cisplatin-unfit patients and whether carboplatin/paclitaxel represents a&#xa0;valid therapeutic alternative. This study investigates the treatment outcomes of patients receiving various platinum-based chemotherapy regimens.</p> Methods <p>Between 2012 and 2022, 170 patients with LAHNSCC were included in the analysis. Overall survival (OS) and progression-free survival (PFS), as well as treatment-related toxicities, were evaluated.</p> Results <p>The included patients were treated with intensity-modulated radiotherapy (IMRT) at a&#xa0;total dose of 59.4–72 Gy, along with 5–6&#xa0;cycles of weekly platinum-based chemotherapy. 130 patients received cisplatin (40 mg/m<sup>2</sup> BSA), while 40&#xa0;patients received carboplatin (AUC&#xa0;1) and paclitaxel (40 mg/m<sup>2</sup> BSA). Median follow-up was 32&#xa0;months. No significant difference was observed in median PFS (<i>p</i> = 0.14; HR 0.74 [0.44–1.26]) nor OS (<i>p</i> = 0.11; HR 0.62 [0.36–1.10]). Subgroup analysis showed that especially patients &lt; 65&#xa0;years and patients in the adjuvant setting benefit from the use of cisplatin.</p> Conclusion <p>Definitive and postoperative radiochemotherapy for the treatment of LAHNSCC with concurrent administration of carboplatin/paclitaxel can be used as a&#xa0;safe and effective alternative but only for cisplatin-ineligible patients.</p>

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Carboplatin/Paclitaxel can be an effective alternative for cisplatin-ineligible patients with locally advanced HNSCC

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2026年8月3日

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  • Stefan Gravemeyer,
  • Jule Hermanns,
  • David R. Steike,
  • Tom Schlusemann,
  • Maximilian Oberste,
  • Armands Riders,
  • Gabriele Reinartz,
  • Claudia Rudack,
  • Hans T. Eich

摘要

Background

Despite considerable therapeutic advances, a significant evidence gap remains regarding optimal treatment strategies for cisplatin-unfit patients and whether carboplatin/paclitaxel represents a valid therapeutic alternative. This study investigates the treatment outcomes of patients receiving various platinum-based chemotherapy regimens.

Methods

Between 2012 and 2022, 170 patients with LAHNSCC were included in the analysis. Overall survival (OS) and progression-free survival (PFS), as well as treatment-related toxicities, were evaluated.

Results

The included patients were treated with intensity-modulated radiotherapy (IMRT) at a total dose of 59.4–72 Gy, along with 5–6 cycles of weekly platinum-based chemotherapy. 130 patients received cisplatin (40 mg/m2 BSA), while 40 patients received carboplatin (AUC 1) and paclitaxel (40 mg/m2 BSA). Median follow-up was 32 months. No significant difference was observed in median PFS (p = 0.14; HR 0.74 [0.44–1.26]) nor OS (p = 0.11; HR 0.62 [0.36–1.10]). Subgroup analysis showed that especially patients < 65 years and patients in the adjuvant setting benefit from the use of cisplatin.

Conclusion

Definitive and postoperative radiochemotherapy for the treatment of LAHNSCC with concurrent administration of carboplatin/paclitaxel can be used as a safe and effective alternative but only for cisplatin-ineligible patients.