Compliance, Toxicity & Survival function analysis of Locoregionally Advanced Squamous Cell Carcinoma of Head and Neck treated with definitive Radiotherapy Concurrent with weekly Cisplatin
Journal Title: JOURNAL OF BIOLOGICAL ENGINEERING RESEARCH AND REVIEW - Year 2017, Vol 4, Issue 2
Abstract
Background: The standard of care for Locoregionally Advanced Squamous Cell Carcinoma of Head and Neck (LASCCHN) is Concurrent Chemo-Radio-Therapy (CCRT), with cisplatin at least 40 mg/m2 per week being standard weekly schedule; so as to keep minimum cumulative dose to be 200 mg/m2. Methods: The present retrospective study was carried out at department of Radiotherapy, SMS Medical College, Jaipur; on 174 patients with LASCCHN treated with definitive 3DCRT (70 Gy in 35 fractions) with concurrent weekly cisplatin; during July 2013 to December 2014. Results were analysed for compliance, toxicity, locoregional control (LRC), and progression free survival (PFS). Results: Compliance to RT & CT was seen in 90.8% & 76.4% patients, respectively. Treatment interruptions were seen in 76.4% of patients, 81.1% patients required hospitalisation at least once, 28.2% patients required feeding nasogastric tube insertion, and 15.5% patients required tracheostomy. At three months, complete response was seen in 81.6% patients. Grade III or higher acute dermatitis was seen in 18.9% of patients, mucositis in 41.9%, dysphagia in 16.7%, xerostomia in 13.2%, vomiting in 10.9%, diarrhea in 2.3%, leucopenia in 1.7%, and anemia in 6.3% of patients. The median follow up was 40 months (range, 31- 48 months). At last follow up, LRC was 66.9%, distant metastases were seen in 12.1% patients, deaths were reported in 8% of patients, and PFS was 71.8%. Conclusion: The findings of present study match with most of the studies cited in literature. Compliance to both CT and RT was good; acute toxicities were within the accepted levels, and were manageable. Higher LRC was significantly associated with stage III (versus IV, P < 0.001), larynx (versus oral cavity, P = 0.02), and ≥5 CT cycles (P = 0.01);, whereas PFS with stage III (versus IV, P < 0.001), larynx (versus oral cavity, P = 0.03), and absence of treatment interruptions (P = 0.03).
Authors and Affiliations
Shivani Gupta, Kartick Rastogi, Shantanu Sharma, Rakesh Gocher, Pawan Kumar, Sandeep Jain
Keywords
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