Evaluation of the efficacy of concurrent cisplatin and radiotherapy in locally advanced head and neck cancer

ABSTRACT

Thirty-six patients with locally advanced unresectable head and neck squamous cell carcinoma were included in this study. All patients received radiotherapy by cobalt60 machine. They received 70 Gy to the tumor area in 35 fractions for 7 weeks and 50 Gy to the uninvolved cervical and supraclavicular LN in 25 fractions for 5 weeks duration [cisplatin]. Concurrent cisplatin [CDDP] was infused in 3 hours and 1/2 hour before radiotherapy. The dose of CDDP was 20 mg/m2 from day 1 to 5, day 22 to 26 and day 43 to 47. The patients were evaluated for response at three weeks after the completion of irradiation and every month for six months, then every three months. The assessment of the response to treatment showed that the overall response was 75% [61% complete remission [CR] and 14% partial remission [PR]]. Six patients showed a stationary course and three patients showed disease progression. Acute toxicity was tolerable and no treatment interruption occurred. The most frequent toxicity was vomiting GI in 21 patients, stomatitis GII in 17 patients and dryness of the mouth GII in 23 patients. Finally, the results of concurrent radio- and chemotherapy were encouraging and a large number of patients and a long time follow up are needed to assess the improvement in survival