Outcome of Concurrent Chemoradiotherapy and Radiotherapy Alone Following Induction Chemotherapy in Locally Advanced Squamous Cell Carcinoma of Head and Neck

Abstract

Non-operative treatment strategies like radiotherapy and chemotherapy are practiced widely nowadays for the treatment of locally advanced squamous cell carcinoma of head and neck origin. Aim of this study was to compare the response of induction chemotherapy followed by radiotherapy alone with induction chemotherapy followed by concurrent chemoradiotherapy in terms of treatment response and toxicities. A quasi-experimental study was carried out in the Department of Radiation Oncology, National Institute of Cancer Research and Hospital (NICR&H), Dhaka; Department of Radiotherapy, Dhaka Medical College Hospital (DMCH), Dhaka and Department of Oncology, Bangabandhu Sheikh Mujib Medical University (BSMMU), Dhaka during the period of January, 2014 to December, 2014. Induction chemotherapy by Cisplatin and 5-Fluorouracil was given to all the patients of Arm A and Arm B. Cisplatin was given concurrently during Radiotherapy weekly in case of Arm A. Arm B received radiotherapy alone. The patients were evaluated from the beginning of the treatment up to six months following the completion of treatment. In this study, male to female ratio was 4:1 and mean age of patients were 54.7±9.1 and 56.6±7.9 in Arm A and Arm B respectively. At final follow-up, complete response was seen in 27 (53.3%) patients of Arm A and Arm B respectively. Response rate was significant (p <0.05) for both the Arms. Acute toxicities observed during induction chemotherapy were almost equal in both the Arms, but during radiotherapy, Arm A had more toxicity though it was statistically insignificant. Induction chemotherapy followed by concurrent chemoradiotherapy is more effective than induction chemotherapy followed by radiotherapy alone in loco-regional control of locally advanced squamous cell carcinoma of head and neck origin.