EVALUATION OF TOXICITY AND COMPLIANCE OF CISPLATIN GIVEN WEEKLY VS THREE WEEKLY CONCURRENTLY WITH RADIOTHERAPY IN HEAD AND NECK CANCER

Dr. Manish Verma, Dr. Ayush Naik

Abstract


Background: Concurrent Chemoradiotherapy with cisplatin is widely accepted modality of treatment for head and neck cancer. Aim: To compare three weekly cisplatin and weekly cisplatin given concurrently along with external beam radiotherapy in locally advanced Head and Neck cancers(LAHNC) for toxicity and response. Materials and Methods: 50 patients of LAHNC were taken for this prospective study. In Arm A 25 patients received 6 cycles of weekly cisplatin 30mg/m2along with radiotherapy and in arm B 2 cycles of Cisplatin 100mg/m2 given 3 weekly along with radiotherapy. Treatment response was seen at the end of treatment as per RECIST v1.01 criteria. All chemotherapy toxicities were graded as per common toxicity criteria v4.0 and all radiation toxicities were graded as per RTOG toxicity criteria. Student unpaired t test was used for statistical analysis. Observations and results: In our study no significant difference was seen in terms of all measured toxicities but hematological toxicities were higher in group B. Regarding acute mucositis and dermatitis, most of them were grade 1 and 2 and were taken care of on outpatient care basis. With regards to response to treatment in our study CR was seen in 56% of patients in group A and 54.5% of patients in group B while 3 (12%) patients had stable disease and 6 (24%) patients had partial response in group A while 1 (4.55%) patient in group B had stable disease and 7 (31.82%) patients had partial response  with no significant difference between both groups. Conclusion:  Weekly cisplatin chemotherapy can provide good alternative to 3 weekly cisplatin  chemotherapy with lesser toxicity.


Keywords


head and neck cancer, Radiotherapy, concurrent Chemotherapy,

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References


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