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Sequential Therapy with Induction Chemotherapy Followed by Concurrent Chemoradiation in Locally Advanced Squamous Cell Carcinomas of the Head and Neck
Article | IMSEAR | ID: sea-202380
ABSTRACT

Introduction:

Induction chemotherapy in locally advancedhead and neck cancers prior to local therapy has beendemonstrated to be non-inferior to concurrent chemoradiationin terms of overall survival (OS). Despite possible lack ofsurvival advantage, downsizing of tumours, allowing organpreservation along with the possible benefit of eradication ofmicrometastases earlier in the course of therapy makes thisa desirable approach for many heads and neck oncologistsworldwide. Study aimed to assess the immediate locoregionalresponse rates and to assess the toxicity profile of sequentialtherapy with three cycles of induction PFT followed byConcurrent Chemo-Radiation with weekly Cisplatin inLocally Advanced Head and Neck Cancers.Material and

methods:

30 consecutive patients with locallyadvanced head and neck cancers attending the OPD at ourinstitute were included in the study. All patients were treatedwith 3 cycles of Induction chemotherapy with PFT regimen(Paclitaxel 175mg/m2 Day1, Cisplatin 100 mg/m² split to(Day 1-3), 5-FU 750 mg/m² Day 1 to 3) every 21 days. Thepatients were then taken up for concurrent chemoradiation(66 Gy RT along with weekly Cisplatin 40mg/sq.m.). Theimmediate locoregional response rates were assessed byclinical and radiological imaging. The toxicity profile of thetreatment was assessed with RTOG acute morbidity scoringcriteria and CTCAE Version 4.

Results:

30 patients (3 female) were recruited for the study.Among them 3 were laryngeal cancer patients and thehypopharyngeal, oropharyngeal and the oral cavity cancerswere 9 each. 63% of them had complete response and 30%had partial response. The sub-sites of the hypopharynx andthe oropharynx had the best outcomes from this treatmentprotocol. 2 patients did not complete the planned treatment.11patients had grade 3 leukopenia and 2 patients had grade 4/febrile neutropenia. There was no grade 3 thrombocytopeniain the study group.

Conclusion:

Sequential therapy with three cycles of inductionPFT followed by concurrent chemoradiation is a feasiblealternative for moderately advanced and very advanced headand neck cancer. Patient selection and supportive care duringtreatment are very important for successful outcome.

Full text: Available Index: IMSEAR (South-East Asia) Year: 2019 Type: Article

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Full text: Available Index: IMSEAR (South-East Asia) Year: 2019 Type: Article