High-dose cisplatin chemoradiation
Checked 2026-09-09
Locally advanced head and neck squamous cell carcinoma, definitive or postoperative (positive margins or extranodal extension)
One cycle
every 21 days × 3 · about 9 weeks in totalComponents
| Drug | Dose | Route | Days | Note |
|---|---|---|---|---|
Cisplatin Cytotoxic chemotherapy (platinum) | 100 mg/m² (weekly 40 mg/m² is the alternative) | IV | D1 | |
Radiotherapy | 2 Gy per fraction, 5 days a week | Radiotherapy | D1, 2, 3, 4, 5, 8, 9, 10, 11, 12, 15, 16, 17, 18, 19 |
Cycles
3 with 70 Gy in 35 fractions (2 cycles is often all that is delivered)
21-day cycle
Emetogenicity
High (>90%)
G-CSF
Not routine
Notes
- Cumulative cisplatin of at least 200 mg/m² is the target; ototoxicity and nephrotoxicity are the cost.
Used in
Products
Source
NCCN Head and Neck Cancers; RTOG 0129; Bernier/Cooper, NEJM 2004
Reference doses for a typical adult from the cited protocol or label. Doses are adjusted for renal and hepatic function, age, performance status and prior toxicity, and institutional protocols vary. Verify against the current label and your local protocol before treating. Not medical advice.
Other regimens for these cancers
Weekly cisplatin chemoradiation (with pembrolizumab for high-risk disease)
Locally advanced cervical cancer (FIGO IB2-IVA); pembrolizumab for FIGO 2014 III-IVA or node-positive
weekly × 5-6
Pembrolizumab monotherapy
Adjuvant melanoma stage IIB-IV (1 year); PD-L1 TPS 50% or above NSCLC; MSI-high tumours; recurrent head and neck (CPS 1 or above)
every 21 days
TPF induction
Locally advanced head and neck cancer where induction is chosen (larynx preservation, bulky nodes)
every 21 days × 3-4
Pembrolizumab + platinum + fluorouracil
Recurrent or metastatic head and neck squamous cell carcinoma, first line
every 21 days
Gemcitabine + cisplatin (nasopharyngeal)
Locoregionally advanced nasopharyngeal carcinoma, induction before chemoradiation; recurrent or metastatic disease with toripalimab
every 21 days × 3