Abstract
Background: Head and neck cancer are very common in India, and most of the patients present with locoregionally advanced disease. Combination of radical surgery and radiotherapy with or without chemotherapy is the standard management. However therapeutic results are poor with this modality. Therefore neoadjuvant chemotherapy and locoregional management by radiotherapy and/or surgery have emerged as a feasible alternative. Methods: 30 patients with locally advanced head and neck cancer, from August 2009 to September 2010, treated with three cycle of neoadjuvant chemotherapy (NACT) using Cisplatin (80 mg/m 2 D1) and Vinorelbine (25 mg/m 2 D1) followed by radical radiotherapy, consisted of total dose up to 60-70 Gy by conventional fractionation schedule. Results: The objective response after NACT was observed in 90% (27/30) patients, with 1 patient had complete response. After completion of radiotherapy 53.4% patients achieved complete response and 43.3% patients achieved partial response. At 6 month follow up 40% patients were disease free. Most common hematological toxicities during NACT were anemia (66.7%) and neutropenia (60%), while mucosities (46.7%) and dysphagia (30%) were most common side effects observed during radiotherapy. Conclusion: The present study has shown that NACT with cisplatin and vinorelbine followed by radical radiotherapy is feasible and well tolerated by patients with locally advanced head and neck cancer. All acute toxicities with grade III & IV were managed conservatively and well. Further large randomized study is needed to judge disease free survival and overall survival.
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