Induction Chemotherapy Versus Upfront Chemoradiation for Locoregionally Advanced of Head and Neck Cancer

Abstract

Aim of the work: evaluatethe response rate , acute and late adverse effects of induction chemotherapy followed by concurrent chemoradiotherapy . secondary end points include overall survival and progression free survival in patients with locoregionally advanced of Squamous cell head and neck cancer (HNSCC) . Patients and Method: A retrospective study of 48 patientswith pathologically proven Stage III-IVB ofSquamous cell head and neck cancer (HNSCC) who presented to the clinical oncology department, sohag University hospital fromJanuary 2010 to March 2017. Patients were treated with induction chemotherapy followed by concurrent chemoradiation therapy or initially concurrentchemoradiation therapy. This study was conducted by hand search in the files and radiotherapy sheetof these patients. Results: Fourty_eight patients with locally advanced head and neck squamous cell carcinoma were included in this study. It was conducted at the Clinical Oncology and Nuclear Medicine Department, Sohag Faculty of Medicine .Of the 48 identified patients, 20 patients received IC followed with CCRT and 28 patients received only CCRT. Therewas no statistically significant difference between both groups as regards response at 24 , 36 and 45 months.In group of CCRT , 18 patients had CR to primary treatment , 7 Patients had PR and 7 Patients had Progressive disease . Ingroup of IC, 12 patients had CR ,6 patients had PR and one patient have Progressive disease . Acute skin reactions andacute mucositiswere experienced by all patients .There was no statistically significant difference between the two groups as regards xerostomia and Chronic skin and subcutaneous toxicity . Conclusion:Our findings did not show that adding induction chemotherapy to chemoradiotherapy was better than concurrent chemoradiotherapy alone in locally advanced head and neck cancer , so the latter remains standard therapy in patients with LAHNC .