For what it's worth, our oncologist at Hopkins felt that *in general* results with carboplatin seem to be equivalent to that for cisplatin. She emphasized that radiation is the "workhorse" of the treatment and that adding chemo improves efficacy by about 10-15%. Even if cisplatin were somewhat more effective, the difference is some percent of a relatively small percent. Individual variation between patients, as well as varying treatment protocols (even at same hospital), makes it hard to "tease out" if difference in result is due to the chemo drug and what is due to other factors.

I have not looked at the trials in the paper Gary cites but it would be very important that the patients enrolled were equivalent in all aspects BUT the chemo drug they received, and that includes whether they were HPV+ or HPV- since this factor alone impacts response to treatment.

Certainly many people are given carboplatin and do very well, and it is certainly far less toxic (although certainly not risk-free). It works in much the same way as cisplatin, forming platinoid bonds within the DNA of cells and preventing cellular repair.

Carbo is usually substituted for cisplatin when the latter is contra-indicated, which includes things like existing hearing loss, kidney issues, and so forth.

Gail