Abstract

NEOADJUVANT CHEMOTHERAPY FOLLOWED BY CONCURRENT CHEMORADIATION IN LOCALLY ADVANCED SQUAMOUS CELL CARCINOMA OF HEAD AND NECK REGION: A SINGLE INSTITUTIONAL STUDY

Dr. Swapan Kumar Mallick*, Dr. Ghafran Nahid and Dr. Rajiv Lochan Jena

Abstract

Introduction: Head and neck cancer is amongst the commonest malignancy in India. Overall 57.5% of global head and neck cancer occur in Asia especially in India. Most of the cases present at a locally advanced stage. Concurrent chemoradiotherapy with or without neoadjuvant chemotherapy are both viable treatment options in locally advanced cases. Materials & Methods: 30 biopsy proven cases of locally advanced head and neck cancer attending the Out Patient Department (OPD) of Radiotherapy from March 2016 to August 2017, meeting specified Inclusion and Exclusion Criteria, willing to participate in the study were included. Patients were treated with neoadjuvant chemotherapy followed by concurrent chemoradiation and followed for a minimum of 8 months. The toxicity and loco-regional control data were assessed. Results: At last follow-up Complete Response, Partial Response, Stable Disease and Progressive Disease was observed in 76.66%, 3.33%, 10% and 3.33% of cases respectively. Haematological toxicities like neutropenia (13.3%), thrombocytopenia (10%) and anemia (20%) were seen. Acute toxicities like oral mucositis and skin reaction were observed in 33.3% and 30% cases respectively and late toxicity like xerostomia was observed in 40% of the cases. Hoarseness and dysphagia were observed in 30% and 56.66% respectively. Conclusions: Neo-adjuvant chemotherapy followed by concurrent chemoradiation gives good locoregional response, but is associated with substantial haematological, gastrointestinal and mucosal toxicity, which is manageable. Thus, neo- adjuvant chemotherapy followed by concurrent chemoradiation is a good option in locally advanced head and neck cancer, which is to be administered weighing the pros and cons of the therapy.

Keywords: Neoadjuvant chemotherapy; Concurrent chemoradiation; Locally advanced head and neck cancers.