Deployment of cisplatin in Veterans with oropharyngeal cancer: toxicity and impact on oncologic outcomes

Objective Cisplatin forms the backbone of systemic chemotherapy treatment for oropharyngeal squamous cell carcinoma (OPSCC). The ideal cisplatin dosing regimen remains yet to be fully defined achieving optimal efficacy and toxicity profiles in patients with comorbidity. Methods We retrospectively reviewed oncologic data OPSCC treated at Michael E. DeBakey Veterans Affairs Medical Center between 2000 2020 who initiated curative intent, definitive chemo-radiation one three single agent regimens: high dose (HD) cisplatin, low (LD) or cetuximab. Results Patients HPV-associated tumors nonsmokers demonstrated improved overall disease-free survival along locoregional distant metastatic control regardless regimen. Regardless selection, which received a cumulative ≥200 mg/m2 had lower rate metastasis. HD resulted greater fraction (75% vs. 50%) receiving comparable measured burden compared LD Conclusions Both regimens can safely delivered Veteran patient population should allow straightforward application conclusions drawn from completed active clinical trials testing regimens. Level Evidence 4.