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_5This 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
