Evaluation of TPF versus Gefitinib in Residual or Recurrent or Metastatic (R/R/M) Head and Neck Carcinoma

Abstract

Worldwide newly diagnosed cases of head and neck cancer in 2012 were 599,637 which was 4.2% of all cancers. Deaths due to head and neck cancer were 324,834 which was 4% of all cancers. The age standardized incidence for head and neck cancers were 12.6 per 100,000 males and 3.7 per 100,000 females. [1] In India alone, 2.5 lakhs new patients of head and neck carcinoma are diagnosed every year, of whom about three-fourths are in an advanced stage. [2] According to the recently published “Million deaths study”, it is one of the commonest malignancies in India and is responsible for 22.9% of cancer related mortality. [3] Locally advanced head and neck cancers include AJCC stage III or IV (T3-4 and/or N1-3, M0) disease at diagnosis. Approximately 70-80% of these patients are diagnosed with locally advanced disease and 30-50% with lymph node involvement. [4] In spite of the relatively good prognosis of the patients with early head and neck cancer treated by standard therapy (surgery or radiotherapy), the prognosis is significantly worse for patients with locally advanced head and neck cancer (LAHNC), with less than 30% of those being cured. [5] In LAHNC, surgery without adjuvant radiotherapy is associated with very poor cure rates. Compared with surgery alone, adjuvant radiotherapy resulted in an approximately 10% absolute increase in 5-year cancer specific survival and overall survival for patients with lymph node-positive head and neck squamous cell carcinoma (HNSCC). [6] Moreover, many locally advanced cases may Abstract