Efficiency of Cisplatin Based Concurrent Chemoradiation in Stages III & IV Head & Neck Squamous Cell Carcinoma

Abstract

Objective: To determine the response of cisplatin-based concurrent chemoradiation in stages III and IV head & neck squamous cell cancer and to evaluate frequency of common toxicities. Introduction: Almost 70% of head and neck cancer patients present with locally advanced disease (stage III and IV). Concurrent chemoradiotherapy is the current standard treatment. Cytotoxic cisplatin is the treatment of choice for concomitant chemoradiotherapy. Cisplatin acts as a radiation sensitizer and advances the antitumor efficacy when combined with radiotherapy. Likewise all chemotherapeutic agents also show side effects including mucositis, dermatitis, nausea & diarrhea. Materials & Methods: A descriptive study conducted in Department of Radiotherapy, Karachi Institute of Radiotherapy and Nuclear Medicine from 2010 to 2011. Fractions with 2 Gy per fraction were completed in 7 weeks. Sample size of 85 enrolled. Total dose of radiotherapy was 66 Gy in 33 fractions. Cisplatin of 100 mg /m² on day 1, 22 and 43 were given. Treatment response was determined radiologically at four weeks. Toxicity was assessed weekly during treatment. Results: Mean age was 55.4 (±10.5) years with Male to Female ratio was 1.3: 1. Thirty (41.1%) patients had achieved complete response (CR), 36 (49.3%) patients had partial response (PR). Significant response rate was 90.4%. p-value was significant <0.05. Most common toxic effects were mucositis 72.6%, vomiting 68.5%, moderate dermatitis 64.4% followed by mild diarrhea 60.3% and dry mouth 54.8%. Overall response of cisplatin was good. Conclusion: A significant response of cisplatin-based chemoradiation achieved. Mucositis was found the most common toxic effect.

Keywords

• head & neck cancer
• cisplatin
• chemoradiation.