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Category: Volume 07 Issue 01 January 2019
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Title: Pure Accelerated Radiotherapy with Concurrent Chemotherapy in State III and IV Head & Neck Squamous Cell Carcinoma

Authors: Vijayasree Thirukurungudi Narayanan, Saravanan Subramaniyan

 DOI: https://dx.doi.org/10.18535/jmscr/v7i1.58

Abstract

 

Background: Stage III-IVB Squamous cell carcinoma in the head & neck region (HNSCC) has been one of the foremost problems among oncologists to achieve good results, even with Combined modality approach. Chemotherapy with radiotherapy in different combinations and different schedules, has been tried by many researchers to achieve good loco-regional control, among those not amenable for surgery. Objective of this study, is to determine the loco regional response and acute toxicity patterns when combining Pure Accelerated Radiotherapy (6 Fractions(Fx)/week) with Concurrent Chemotherapy in patients with  advanced  loco  regional HNSCC.          

Methods: Patients presented to our Department with previously untreated stage III - stage IV HNSCC with age between 18yrs and 60 yrs of either gender, without systemic spread, were included in our study. They were treated with radical external radiation 6600 cGy/33(Fx), 200cGy/Fx, 6Fx/Week over 5.3 weeks (38 days) and concurrent chemotherapy Cisplatin (100 mg/m2) administered intravenously on days 1 and 22 of Radiotherapy. The primary end-point of the study was the loco regional response at 6 weeks. Additional end point includes acute toxicity rate.

Results: Among 28 patients recruited, 25 patients completed full course of treatment. 21 patients (84%) had complete response in and 4 (16%) had partial response, among them, 3(12%) patients had residual disease at nodal site, and 1(4%) at the primary and nodal site.7 (28%) and 17 (70.8%) patients experienced acute Grade-III and grade-II side effects respectively.

Conclusions: This data shows that it is feasible to combine Accelerated Radiotherapy and full dose mono-chemotherapy with manageable, although substantial, toxicity. The hospital stay is reduced. Hence it is an effective alternate regimen in centers with high work load. 

Keywords: Squamous cell carcinoma, Head and neck cancers, concurrent chemoradiation, Altered Fractionation.

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Corresponding Author

Vijayasree T N

Associate Professor Govt Royapettah Hospital & Kilpauk Medical College, Chennai, Tamilnadu, India

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