Study to evaluate the acute toxicities and response to concurrent chemoradiotherapy with weekly cisplatin versus cisplatin and paclitaxel in locally advanced head-and-neck cancer

Abstract

Objective: The objective of this study is to assess the acute toxicities and locoregional response rates in patients with locally advanced head-and-neck squamous cell carcinomas with intensity-modulated radiotherapy (IMRT) and weekly cisplatin versus weekly cisplatin and paclitaxel. Methodology: Fifty-four patients with histologically proven squamous cell carcinoma of the head and neck at the department of radiotherapy, at our hospital, were taken up for this study. Patients were allotted to the study and control arm and results were analyzed. All patients were treated with IMRT 70 Gy along with weekly injection cisplatin 35 mg/m2 (control arm) versus IMRT 70 Gy along with weekly injection paclitaxel 30 mg/m2 and injection cisplatin 20 mg/m2 (study arm). The toxicity profile was assessed weekly during treatment and then monthly for 3 months postchemoradiotherapy with Common Terminology Criteria for Adverse Events (CTCAE) version 5.0. The immediate locoregional response rates were assessed clinically postchemoradiotherapy and then monthly for 3 months after concurrent chemoradiotherapy. Results: In this study, oropharyngeal cancer dominated with 52% of patients in the study arm and 47% in the control arm. Most of the patients were in Stage IV a (69%). Toxicities were observed more in the study arm with 59% of patients with Grade 3 mucositis and 52% of patients with Grade 3 dermatitis. Eighty-one percent of patients in the study arm and 70% of patients in the control arm had Grade 3 dysphagia. Grade 2 leukocytopenia was seen in 44% of patients in the study arm and 19% in the control arm. Complete and partial responses at the end of follow-up were 70% and 30% in the study arm and 48% and 52% in the control arm, respectively. Conclusion: Concurrent chemoradiotherapy with injection cisplatin and paclitaxel in locally advanced squamous cell carcinoma of the head and neck has a higher complete response rate with manageable toxicities.