Concurrent Chemoradiation with Weekly Gemcitabine and Cisplatin in Locally Advanced Carcinoma of the Head and Neck

Abstract

ABSTRACT Aim: To assess immediate locoregional response to concurrent chemoradiation with gemcitabine and cisplatin in locally advanced head and neck cancer and to assess the toxicity. Methods: 30 patients of stage 3 and 4 squamous cell carcinoma of head and neck were taken for this single arm prospective study .They were treated with gemcitabine 20mg/m2 and cisplatin 30mg/m2 once a week, concurrent with radiotherapy in a conventional fractionated manner of 2Gy per fraction, up to a total of 70Gy, 5 days a week, completed in 7 weeks. The response to treatment and acute toxicity were assessed clinically, during treatment and after 4-6 weeks of treatment. Toxicities were graded using RTOG acute morbidity criteria and CTCAE criteria. Results: The complete and partial response rates were 80% and 20%, respectively. 46% had grade 1 haematological toxicity. No renal toxicity was seen. 73.3% had grade 3 mucositis, 16% from grade 2. 36.6% showed grade 3 skin reaction. Compared with concurrent chemoradiation with weekly cisplatin, this study showed an increase in complete response (80% vs 60%), but an increase in mucosal toxicity was also seen, which was statistically significant. Conclusions: Concurrent chemoradiation with weekly gemcitabine and cisplatin shows promising results with slightly high but manageable toxicity. However, randomized trials are needed in future to further validate this regimen. Disclosure: All authors have declared no conflicts of interest.