There are a few of us here and hopefully we stay that way Margaret! I do also think that since the demographics are changing the stats will eventually as well. Since traditionally its been elderly drinkers, and smokers, that suffer this disease health for them is usually compromised, and their willingness to stop smoking and drinking also comes into play so this all feeds the statistics. Hugs

Hi! I had radical neck doc remove one 3.5 cm node +2nd robotic doc remove primary bot same surgery day. 5 weeks post op. Now awaiting 6weeks radiation at 60 g??? + 6 sessions carboplatin. Oncologist states No side effects from this drug due to anti nausea first and the 6 sessions vs. Erbitux or Cisplatin which he does not use? I hardly believe the No Side Effects?? What's the truth?? I had clean margins and only one node and no extrcapsular spread. Another oncologist told me he would do radiation alone?? Oh yes, HPV+16! Recent PET scan negative except one suspicious node same area which the radiation will get. Thanks! Mark Cohen in LA treated completely at UCLA

No such thing. All drugs have side effects. Carboplatin may have less side effects than cisplatin, but not as effective, close, and a good alternative for some. Good luck with everything.

[quote=PaulB]No such thing. All drugs have side effects. Carboplatin may have less side effects than cisplatin, but not as effective, close, and a good alternative for some. Good luck with everything. [/quote]Hey Paul, Do you have any links to vetted trails or papers demonstrating the efficacy of the main chemo drugs: Cisplatin, Carboplatin, Erbitux (cetuximab) and also the number and degree of side effects?

It seems cisplatin is the most effective but has more side effects. Carboplatin seems the second choice and is still platium based while Erbitux is used as a third resort.

My MO has be scheduled during concurrent chemo-radiation to receive weekly carboplatin rather than cisplatin. On on hand I am OK with that as that maybe means less side effects but also may be not as fully as effective as going with cisplatin.

One reason you are probably having carboplatin is because you are having cisplatin with IC, so there is risk you can become resistant to the cisplatin or may be less effective.

True. I was also thinking that there may be concern with excessive dosing of cisplatin and probability of side effects such as hearing loss and long term tinnitus increase to warrant something else but carbo is still platinum based so not sure how much it helps in reality.

Questions will be asked to both RO and MO about the chemo interaction with the rads beyond the basic radio sensitivity improving performance of rads.

I have time so I guess I will go hunt down the articles and trials myself. Arf Arf
don

Yes, toxicities is another factor. Carboplatin works differently on the DNA, than Cisplatin does, but I don't have any trials or info handy with the three drug regimens with all that info or comparisons side by side. Seems most info are scattered about, not cut & dry with different type cancers, drug regimines, radiation or not, etc. If I come across any, I'll let you know.

Here is some info for Induction Chemo, with concurrent cemoradiation with carboplatin, which you may have seen, but has adverse toxicities side by side with TPF vs PF

http://www.hopkinsmedicine.org/otol...20diagnosis%20induction%20with%20TPF.pdf

Here is another study with Cisplatin vv Carboplatin for nasopharyngeal cancer, that lists sdvese effects in both.

http://www.ncbi.nlm.nih.gov/pubmed/17467265

Cisplatin vs Carboplatin HNC:

http://www.medscape.com/viewarticle/708054_6

Doesn't seem like you have much of a choice. Dr already said carboplatin, you already had TPF IC, Taxotere, Cisplatin and 5-FU, and they say Erbitux is not recommended to be used outside clinical trials for initial treatment, although anything can be used outside clinical trials.

Hi Paul,
Thanks for the links.

JH link
PF vs TPF study. posner
Read this one earlier.

NCBI link
Interesting as it recommends carbo over cisplatin due to improved overall survival rate I surmise. This trial was for NPC patients, not laryngeal, and also was conducted using a 3 week infusion cycle. The treatment plan from my MO schedules weekly lower fractionalized dosage, same total, in the plan as he is quite focused on both outcome and reducing side effects.

Cisplatin vs carboplatin completion rates 42% vs 70%, yet overall survival rates 77.7% and 79.2%. This seems quite astounding that there can be that much drop out in cisplatin yet less than 2% overall difference in efficacy. Makes me think new trials conducted on dosage reduction in HPV+ regimens will likely allow reduction from standard of care 70 grays. I know another patient who went to 60grays during current chemo-radidation phase.

MS link
http://www.medscape.com/viewarticle/708054_5
This page (previous) covers this a bit more broadly.

I think I will ask both the RO and MO on my next visits and also at possible second tumor board as I believe my case may go again before finalizing the concurrent chemo-radiation treatment, if weekly dosing of cisplatin might be a better option, especially if my experience so far with cisplatin induction chemo is a reliable indicator for the concurrent phase and it is fractionalized to weekly infusion. I had no nausea or vomitting to speak of so far during induction TPF but this is at least in part due to the 4 cycle fractionalization rather than more common 3 cycle dosing.

Don

Completion of treatment (full compliance) is a factor in the success of any treatemt, so this has to be weighed. Here is a link for Weekly vs three large Cisplatin infusions. I also read elsewhere, but older material, that weekly smaller infusions was equivalent in having radiation alone, but this study may show not much difference, if not better outcome, although they say not significant. Also interesting was the weekly lower dose infusions had more mucosictis than the larger doses.

http://apocpcontrol.com/paper_file/issue_abs/Volume12_No5/1185-88%20c%204.1%20Fatih%20Kose.pdf