Cumulative cisplatin dose in concurrent chemoradiotherapy for head and neck cancer: A systematic review

Head Neck. 2016 Apr:38 Suppl 1:E2151-8. doi: 10.1002/hed.24026. Epub 2015 Jul 14.


Background: The optimal cumulative dose and timing of cisplatin administration in various concurrent chemoradiotherapy protocols for nonmetastatic head and neck squamous cell carcinoma (HNSCC) has not been determined.

Methods: The absolute survival benefit at 5 years of concurrent chemoradiotherapy protocols versus radiotherapy alone observed in prospective randomized trials reporting on the use of cisplatin monochemotherapy for nonnasopharyngeal HNSCC was extracted. In the case of nonrandomized studies, the outcome results at 2 years were compared between groups of patients receiving different cumulative cisplatin doses.

Results: Eleven randomized trials and 7 nonrandomized studies were identified. In 6 definitive radiotherapy phase III trials, a statistically significant association (p = .027) between cumulative cisplatin dose, independent of the schedule, and overall survival benefit was observed for higher doses.

Conclusion: Results support the conclusion that the cumulative dose of cisplatin in concurrent chemoradiation protocols for HNSCC has a significant positive correlation with survival. © 2015 Wiley Periodicals, Inc. Head Neck 38: E2151-E2158, 2016.

Keywords: cisplatin; concurrent chemoradiotherapy; cumulative dose; outcome; radiotherapy.

Publication types

  • Review
  • Systematic Review

MeSH terms

  • Antineoplastic Combined Chemotherapy Protocols
  • Carcinoma, Squamous Cell / therapy*
  • Chemoradiotherapy*
  • Cisplatin / therapeutic use*
  • Clinical Trials, Phase III as Topic
  • Disease-Free Survival
  • Dose-Response Relationship, Drug
  • Head and Neck Neoplasms / therapy*
  • Humans
  • Non-Randomized Controlled Trials as Topic
  • Randomized Controlled Trials as Topic
  • Treatment Outcome


  • Cisplatin