Without
contraindications
to cisplatin
With a
contraindication
to cisplatin
With a
contraindication
to platinum-based
chemotherapy
Without
contraindications
to cisplatin
With a
contraindication
to cisplatin
With a
contraindication
to platinum-based
chemotherapy
Concurrent
Adjuvant
Platinum-based regimens should be offered. The
following regimens may be used in the absence
of medical contraindications: GP (gemcitabine:
1000 mg/m
2
d1, d8; cisplatin 80 mg/m
2
d1) or
TPF (docetaxel 60–75 mg/m
2
d1; cisplatin 60–75
mg/m
2
d1; 5-FU 600–750 mg/m
2
per day, civ
d1–5); others include PF (cisplatin 80–100 mg/m
2
d1; 5-FU 800–1000 mg/m
2
per day, civ d1–5), PX
(cisplatin 100 mg/m
2
d1; capecitabine 2000 mg/
m
2
per day, d1–14) and TP (docetaxel 75 mg/m
2
d1; cisplatin 75 mg/m
2
d1)
The regimens should
be administered every
3 weeks for a total
of 3 cycles, or at the
minimum 2 cycles;
chemoradiotherapy
should be commenced
within 21–28 days from
the first day of the
last cycle of induction
chemotherapy
Cisplatin, given weekly (40 mg/)m
2
)
or triweekly (100 mg/m
2
, or at least
80 mg/m
2
), should be offered;
3 doses of triweekly or 7 doses
of weekly cisplatin should be
attempted to achieve a cumulative
dose of at least 200 mg/m
2
Nedaplatin (100 mg/m
2
triweekly)
may be offered for concurrent
chemoradiotherapy. Other
options that may be offered are
carboplatin (AUC 5–6 triweekly) or
oxaliplatin (70 mg/m
2
weekly)
Fluoropyrimidines
(e.g., capecitabine, 5-FU, tegafur)
with concurrent radiotherapy
may be offered
PF (cisplatin 80 mg/m
2
d1 or
20 mg/m
2
per day, d1–5; 5–FU
1000 mg/m
2
per day, civ d1–4,
or 800 mg/m
2
per day, civ d1–5)
administered every 4 weeks for a
total of 3 cycles should be offered
Carboplatin (AUC 5) may be
combined with 5-FU
The use of non-platinum-based
regimens remain experimental at
this time and should not be offered
routinely outside the context of a
clinical trial
a
ere's a lack of head-to-head trials comparing induction chemotherapy plus concurrent
chemoradiotherapy versus concurrent chemoradiotherapy plus adjuvant chemotherapy.
