CONCURRENT CHEMO RADIOTHERAPY WITH WEEKLY CISPLATIN VERSUS WEEKLY CARBOPLATIN IN LOCALLY ADVANCED ORAL CAVITY CANCERS

Dr Preety Jain, Dr Garima Uikey, Dr Manish Verma, Dr Pranjil Mandloi, Dr Vikas Pal, Dr Vipin Kumar Dubey, Dr Jyoti Dane

Abstract


INTRODUCTION
Head and neck cancers are among the 10 most common
cancers globally and are the most common cancers in
developing countries, especially in South East Asia. In India,it
accounts for one fourth of male cancers and one tenth of
female cancers.Oral cancers are most common amongst all
head and neck squamous cell carcinoma(HNSCC). This
mainly attributed to tobacco,areca nut, alcohol, etc.[1]
According to Cancer statistics of India cancer of oral cavity
and lung account for over 25 % of cancer death in male [2].
Concurrent chemoradiation,has become the standard
treatment option for locally advanced head and neck
squamous cell cancer, since several randomized trials
r e p o r t e d a s i g n i  c a n t s u r v i v a l b e n e  t o f a d d i n g
chemotherapy to radiation over radiation alone [3-
6].Cisplatin is among the most common agents used in
combination with radiotherapy as well as one of the most
studied. It has radiosensitizing properties and it's toxicity does
not overlap radiotherapy [4].In an attempt to increase to local
control in advanced head and neck cancers chemotherapy
has been used before or after surgery and has been
associated with good clinical response. Combined
chemotherapy and radiation used simultaneously to get
synergistic benet against head and neck cancers has been
associated with high level of response in in-operable disease.
T h e m o s t c o m m o n d r u g s u s e d a r e c i s p l a t i n , 5 -
uorouracil,hydroxyurea and mitomycin [7]. Carboplatin has
radiosensitizing properties and has lesser renal and
gastrointestinal toxicities than cisplatin and is considered an
effective option in National Comprehensive Cancer Network
(NCCN) guidelines for patients unt for cisplatin. Phase II
studies of carboplatin based CTRT showed complete
response of 65%-70% ,similar to those seen in cisplatin[8].


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