Summary for doctors

After surgery with positive margins or extracapsular extension, and definitive chemoradiotherapy ^[1].
In a randomised study, every 3 weeks gave better locoregional control than weekly ^[2].
Target cumulative dose at least 200 mg/m².

Dose and schedule

Cisplatin every 3 weeks

With radiotherapy 60 to 70 Gy

Drug	Dose	Route	Schedule
Cisplatin	100 mg/m²	IV	Days 1, 22 and 43

Cycle length: Every 21 days during radiotherapy
Duration: 3 doses

As in RTOG 9501 ^[1].

Weekly cisplatin

When a high dose is not suitable

Drug	Dose	Route	Schedule
Cisplatin	30 mg/m²	IV	Weekly

Cycle length: Weekly during radiotherapy
Duration: 6 to 7 doses

The dose of the weekly arm in the Noronha study; locoregional control in this arm was lower ^[2].

Doses follow the trial protocol, guideline or official drug label (source given in the notes of each regimen). Before prescribing, check blood counts, renal and hepatic function, drug interactions and the patient’s condition, and adjust the dose according to the drug label.

Premedication and supportive care

Hydration before and after cisplatin, magnesium and potassium; highly emetogenic antiemetics for 100 mg/m².
Nutrition: early assessment; a feeding tube with weight loss or severe mucositis.
Oral hygiene and dental assessment before radiotherapy.

Monitoring and dose adjustment

Creatinine, electrolytes and blood counts before each dose; baseline audiometry.
Creatinine clearance below 50 to 60: cisplatin is not suitable.

Main evidence

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RTOG 9501: after high-risk surgery, cisplatin with radiotherapy improved locoregional control and disease-free survival ^[1]. In the Noronha study, 2-year locoregional control was 58.5% with cisplatin 30 mg/m² weekly vs 73.1% with 100 mg/m² every 3 weeks ^[2].

Related cancer types

Head and neck cancers

Treatment regimens (physicians)

TPF (induction) regimen in head and neck cancer First-line regimens for recurrent or metastatic head and neck cancer: pembrolizumab and EXTREME

References

2 references

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Numbers in the text, such as ^[1], refer to these sources. Sources with a “Study card” button are summarised in the site’s evidence library.

1
Postoperative concurrent radiotherapy and chemotherapy for high-risk squamous-cell carcinoma of the head and neckCooper JS, Pajak TF, Forastiere AA, et al · N Engl J Med · 2004;350:1937-44
DOI PubMed Back to text: 1 2 3
2
Once-a-Week Versus Once-Every-3-Weeks Cisplatin Chemoradiation for Locally Advanced Head and Neck Cancer: A Phase III Randomized Noninferiority TrialNoronha V, Joshi A, Patil VM, et al · J Clin Oncol · 2018;36:1064-1072
DOI PubMed Back to text: 1 2 3

This page is based on reputable scientific sources and was last updated on 28 October 2026. The content of this website is for educational and informational purposes only and does not replace consultation, diagnosis or treatment by a specialist physician. Consult your treating physician about any treatment decision.

Printed from the website; the full and up-to-date version: https://drdabiri.com/en/regimens/cisplatin-radiotherapy-head-neck/

Cisplatin with radiotherapy in head and neck cancer