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Category: Volume 08 Issue 02 February 2020
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Title: Efficacy of Concurrent Chemoradiation in Locally Advanced Squamous Cell Carcinoma of Head and Neck

Authors: L.Karpagavalli, Joneetha Jones, K.Sureshkumar

 DOI: https://dx.doi.org/10.18535/jmscr/v8i2.80

Abstract

   

Aims & Objectives: To analyse the loco regional control and acute toxicity in patients with locally advanced squamous cell carcinoma of the head and neck (oropharynx and larynx) in Conventional concurrent radiotherapy with weekly Cisplatin.

Materials and Methodology: A single arm prospective study of 30 consecutive cases of newly diagnosed patients with locolly advanced  Stage III & IVA Squamous cell carcinoma of oropharynx & larynx enrolled .All patients were irradiated with conventional fractionation to a dose of 66 Gy in 33 fractions over 6.5–7 weeks along with weekly Inj. Cisplatin 40mg/. The immediate locoregional response rates were assessed clinically and toxicity profile of the treatment was assessed with RTOG acute morbidity scoring criteria .The study was statistically analysed using Chi Square test.

Results: Out of thirty patients, seven percent (7%) have undergone tracheostomy. Out of thirty patients, eighty three (83%) were having complete response and seventeen percent (17%) were having partial response. All the patients experienced at least grade 1 skin reaction after 40 – 45 Gy. No grade 4 skin reactions were seen. Twenty three i.e. 77% patients had grade 2 patchy mucositis and 5 had grade 3 confluent mucositis.

Conclusion: The present schedule is well tolerated for all patients and can be safely used in older patients and patients with controlled co-morbidities. This conventional fractionation schedule suits the busy and heavy patient load in our institute and is highly cost effective.

Keywords: concurrent chemoradiation, weekly cisplatin, locoregional control, mucositis, skin reaction.

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Corresponding Author

Dr L.Karpagavalli

Assistant Professor, Dept of Radiotherapy, Tamilnadu Government Multi Super Speciality Hospital, Chennai, Tamil Nadu, India