Chemotherapy in Head and Neck Cancer Clinical Predictors of Tolerance and Outcomes

Background: The addition of chemotherapy is more efficacious than radiation alone in the treatment of head and neck cancer (HNC). However, little data are available regarding the best chemotherapy agent and dosing, or factors associated with chemotherapy compliance. Methods: Retrospective review of all HNC patients receiving combined chemotherapy and radiotherapy at the University of Kansas Medical Center between 1994 and 2006. A total of 172 patients were analyzed in this report. Results: A total of 37% of patients were able to complete the entire chemotherapy regimen as intended. Multiple factors were examined in relation to chemotherapy completion and clinical outcome. Factors associated with not being able to complete chemotherapy on Cox regression analysis include use of a platinum agent and older age at diagnosis. No chemotherapy-related variables were prognostic for overall survival or disease-free survival. Conclusion: Factors associated with reduced chemotherapy compliance include older age and cisplatin agent. None of the chemotherapy characteristics (agent, total dose, and schedule) were associated with outcome.