Outcome of Concurrent Chemoradiation after Induction Chemotherapy in Locally Advanced Head and Neck Squamous Cell Carcinoma - A Prospective Study among Patients Attending a Tertiary Care Center in Kerala, India

Preeya Vasanthakumary, Binitha Tresa Thomas, Devi Mohan
{"title":"Outcome of Concurrent Chemoradiation after Induction Chemotherapy in Locally Advanced Head and Neck Squamous Cell Carcinoma - A Prospective Study among Patients Attending a Tertiary Care Center in Kerala, India","authors":"Preeya Vasanthakumary, Binitha Tresa Thomas, Devi Mohan","doi":"10.14260/jemds.v12i1.322","DOIUrl":null,"url":null,"abstract":"BACKGROUND \nConcurrent chemoradiation (CCRT) is the standard of care for locally advanced head and neck squamous cell carcinoma (LAHNSCC). In settings with considerable waiting period for radiation, institutional protocols advocate induction chemotherapy before CCRT. This study aimed to assess the outcome of concurrent chemoradiation after induction of chemotherapy among patients with LAHNSCC attending a tertiary care radiotherapy center in Kerala, India. \nMETHODS \nPatients with non-metastatic LAHNSCC (stage 111 and 1V) with good performance score of 0-1 who received induction chemotherapy (with docetaxel 75mg/m2and cisplatin 75 mg/m2, day 1 and 5-fluorouracil 750 mg/m2, day 1 and 2 as infusion every 3 weeks for 3 cycles) followed by CCRT (with concurrent cisplatin 40 mg/m2 weekly) were selected for the study. CCRT was administered only to those patients who showed more than 30 % response to induction chemotherapy. They were followed up for 24 months. The primary end point was the clinical response assessed by ENT evaluation 8 weeks after the completion of CCRT. \nRESULTS \n117 patients with LAHNSCC were enrolled. Four patients (3.4 %) dropped out after induction therapy. Out of 113 patients who initiated concurrent chemo radiation, two patients (1.7 %) dropped out while on CCRT, two patients (1.7 %) were intolerant to CCRT and two patients (1.7 %) left soon after CCRT. 107 patients were available for follow up after treatment completion. Acute toxicities were noticed in 9 (7.7 %) while on induction treatment. Mucositis occurred in 1 (0.9 %), haematological toxicities in 4 (3.4 %), gastrointestinal toxicities in 2 (1.7 %) and fatigue and malaise in 2 (1.7 %). In patients who underwent concurrent chemo radiation, 53 (49.03 %) had acute mucosal, skin, GIT and haematological toxicities. On treatment completion, 82 patients (70.1 %) had complete response, 24 (20.5 %) had partial response and one (0.9 %) had stable disease. During the follow up period of 24 months, locoregional failure (relapse) was noted in 15 patients (12.8 %) while 61 patients (52.1 %) remained disease free. Organ preservation rate was 53.4 % for laryngeal primaries. 4 patients (3.4 %) developed distant metastases during the follow up. \nCONCLUSIONS \nInduction chemotherapy with docetaxel containing regime followed by concurrent chemoradiation was associated with good clinical response and acceptable toxicity profile.","PeriodicalId":47072,"journal":{"name":"Journal of Evolution of Medical and Dental Sciences-JEMDS","volume":" ","pages":""},"PeriodicalIF":0.0000,"publicationDate":"2023-01-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Journal of Evolution of Medical and Dental Sciences-JEMDS","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.14260/jemds.v12i1.322","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"","JCRName":"","Score":null,"Total":0}
引用次数: 0

Abstract

BACKGROUND Concurrent chemoradiation (CCRT) is the standard of care for locally advanced head and neck squamous cell carcinoma (LAHNSCC). In settings with considerable waiting period for radiation, institutional protocols advocate induction chemotherapy before CCRT. This study aimed to assess the outcome of concurrent chemoradiation after induction of chemotherapy among patients with LAHNSCC attending a tertiary care radiotherapy center in Kerala, India. METHODS Patients with non-metastatic LAHNSCC (stage 111 and 1V) with good performance score of 0-1 who received induction chemotherapy (with docetaxel 75mg/m2and cisplatin 75 mg/m2, day 1 and 5-fluorouracil 750 mg/m2, day 1 and 2 as infusion every 3 weeks for 3 cycles) followed by CCRT (with concurrent cisplatin 40 mg/m2 weekly) were selected for the study. CCRT was administered only to those patients who showed more than 30 % response to induction chemotherapy. They were followed up for 24 months. The primary end point was the clinical response assessed by ENT evaluation 8 weeks after the completion of CCRT. RESULTS 117 patients with LAHNSCC were enrolled. Four patients (3.4 %) dropped out after induction therapy. Out of 113 patients who initiated concurrent chemo radiation, two patients (1.7 %) dropped out while on CCRT, two patients (1.7 %) were intolerant to CCRT and two patients (1.7 %) left soon after CCRT. 107 patients were available for follow up after treatment completion. Acute toxicities were noticed in 9 (7.7 %) while on induction treatment. Mucositis occurred in 1 (0.9 %), haematological toxicities in 4 (3.4 %), gastrointestinal toxicities in 2 (1.7 %) and fatigue and malaise in 2 (1.7 %). In patients who underwent concurrent chemo radiation, 53 (49.03 %) had acute mucosal, skin, GIT and haematological toxicities. On treatment completion, 82 patients (70.1 %) had complete response, 24 (20.5 %) had partial response and one (0.9 %) had stable disease. During the follow up period of 24 months, locoregional failure (relapse) was noted in 15 patients (12.8 %) while 61 patients (52.1 %) remained disease free. Organ preservation rate was 53.4 % for laryngeal primaries. 4 patients (3.4 %) developed distant metastases during the follow up. CONCLUSIONS Induction chemotherapy with docetaxel containing regime followed by concurrent chemoradiation was associated with good clinical response and acceptable toxicity profile.
查看原文
分享 分享
微信好友 朋友圈 QQ好友 复制链接
本刊更多论文
局部晚期头颈部鳞状细胞癌诱导化疗后同步放化疗的结果-印度喀拉拉邦三级保健中心患者的前瞻性研究
背景:同步放化疗(CCRT)是局部晚期头颈部鳞状细胞癌(LAHNSCC)的标准治疗方法。在放疗等待时间较长的情况下,机构方案提倡在CCRT前进行诱导化疗。本研究旨在评估在印度喀拉拉邦三级护理放疗中心接受LAHNSCC患者诱导化疗后同步放化疗的结果。方法选择表现评分为0-1分的非转移性LAHNSCC(111期和1V期)患者,接受诱导化疗(多西他赛75mg/m2 +顺铂75mg/m2,第1天,5-氟尿嘧啶750 mg/m2,第1天和第2天输注,每3周,共3个周期),然后进行CCRT(同时顺铂40mg /m2,每周)。CCRT仅用于对诱导化疗反应超过30%的患者。他们被随访了24个月。主要终点是完成CCRT后8周通过耳鼻喉科评估评估的临床反应。结果入选117例LAHNSCC患者。4例患者(3.4%)在诱导治疗后退出。在113名开始同步放化疗的患者中,2名患者(1.7%)在CCRT期间退出,2名患者(1.7%)对CCRT不耐受,2名患者(1.7%)在CCRT后不久离开。107例患者治疗完成后可随访。诱导治疗时出现急性毒性9例(7.7%)。粘膜炎1例(0.9%),血液学毒性4例(3.4%),胃肠道毒性2例(1.7%),疲劳和不适2例(1.7%)。在接受同步放化疗的患者中,53例(49.03%)出现急性粘膜、皮肤、胃肠道和血液学毒性。治疗结束时,82例患者(70.1%)完全缓解,24例(20.5%)部分缓解,1例(0.9%)病情稳定。在24个月的随访期间,15例(12.8%)患者出现局部失败(复发),61例(52.1%)患者无病。喉部原发病变的器官保存率为53.4%。4例(3.4%)患者在随访期间发生远处转移。结论:多西紫杉醇诱导化疗后同步放化疗具有良好的临床疗效和可接受的毒性特征。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
求助全文
约1分钟内获得全文 去求助
来源期刊
自引率
0.00%
发文量
180
期刊最新文献
Emphysematous Pyelonephritis with Extension of Air in the Inferior Vena Cava Cytomorphological Pattern of Neoplastic and Non-Neoplastic Breast Lesions - An Institutional Experience of a Rural Tertiary Care Center Nephrotic Syndrome in Pregnancy - Case Reports Case Report - Trauma Induced Vernet’s Syndrome Leptomeningeal Metastases in Carcinoma Rectum with Extensive Skeletal Metastasis - A Case Report
×
引用
GB/T 7714-2015
复制
MLA
复制
APA
复制
导出至
BibTeX EndNote RefMan NoteFirst NoteExpress
×
×
提示
您的信息不完整,为了账户安全,请先补充。
现在去补充
×
提示
您因"违规操作"
具体请查看互助需知
我知道了
×
提示
现在去查看 取消
×
提示
确定
0
微信
客服QQ
Book学术公众号 扫码关注我们
反馈
×
意见反馈
请填写您的意见或建议
请填写您的手机或邮箱
已复制链接
已复制链接
快去分享给好友吧!
我知道了
×
扫码分享
扫码分享
Book学术官方微信
Book学术文献互助
Book学术文献互助群
群 号:481959085
Book学术
文献互助 智能选刊 最新文献 互助须知 联系我们:info@booksci.cn
Book学术提供免费学术资源搜索服务,方便国内外学者检索中英文文献。致力于提供最便捷和优质的服务体验。
Copyright © 2023 Book学术 All rights reserved.
ghs 京公网安备 11010802042870号 京ICP备2023020795号-1