Interim analysis: Combined modality treatment in advanced head and neck cancer

ABSTRACT

This work aimed to optimize the locoregional control in locally advanced head and neck cancer by concurrent chemoradiation using the concomitant boost subtype of accelerated fractionation radiotherapy. Also, the safety profile of this combined modality was assessed. Twenty-three patients with locally advanced head and neck cancer were recruited. Their median age was 53 and performance status 1-2 [WHO]. Larynx was the commonest site of primary disease in 11 cases [48%], the nasopharynx 8 cases [35%], the hypopharynx 3 cases [13%] and the oropharynx one case [4%]. T3-4 was seen in 20 cases [88%] and N2-3 in 7 cases [30%]. The median total dose of radiation was 71.5 Gy with median concomitant boost 10 Gy. The biologic effective dose with time correction in this study was 59.2 Gy 10. Concurrent cisplatinum was prescribed in a dose of 80 mg/m2/3 weeks. The recorded relative dose intensity of cisplatin was 0.75. The results revealed that the commonest recorded grade 3/4 [WHO] toxicity was mucositis [dysphagia] in 8 cases [35%] followed by vomiting in 7 cases [30%] and asthenia in 5 cases [22%]. However, all cases showed objective response to treatment with 15 cases [65%] in complete response sustained to the end of the study. The treatment is fairly tolerated by the patients included in this study with satisfactory locoregional control of their advanced disease