Sequential therapy (triple drug-based induction chemotherapy followed by concurrent chemoradiotherapy) in locally advanced inoperable head and neck cancer patients - Single institute experience
Context: India has a high incidence of head and neck squamous cell carcinoma (HNSCC) mostly presenting in advanced stage. In the majority of inoperable patients a combination of chemotherapy and radiotherapy (CRT) is considered as the treatment of choice. Adding induction chemotherapy (ICT) before C...
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| Format: | Article |
| Language: | English |
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Thieme Medical and Scientific Publishers Pvt. Ltd.
2011-01-01
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| Series: | Indian Journal of Medical and Paediatric Oncology |
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| Online Access: | http://www.ijmpo.org/article.asp?issn=0971-5851;year=2011;volume=32;issue=2;spage=86;epage=91;aulast=Somani |
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| author | Naresh Somani S Goyal R Pasricha N Khuteta P Agarwal A K Garg H Singhal |
| author_facet | Naresh Somani S Goyal R Pasricha N Khuteta P Agarwal A K Garg H Singhal |
| author_sort | Naresh Somani |
| collection | DOAJ |
| description | Context: India has a high incidence of head and neck squamous cell carcinoma (HNSCC) mostly presenting in advanced stage. In the majority of inoperable patients a combination of chemotherapy and radiotherapy (CRT) is considered as the treatment of choice. Adding induction chemotherapy (ICT) before CRT has shown to decrease systemic relapse. Incorporation of taxanes to the cisplatin and 5-FU-based ICT has shown increase in response rates. Aims: To evaluate the efficacy and toxicity of triple drug-based ICT followed by CCRT in locally advanced, inoperable HNSCC in the Indian context. Settings and Design: Prospective, non-controlled, observational study, a single-institute experience. Materials and Methods: Consecutive, locally advanced inoperable HNSCC patients were put on sequential therapy consisting of docetaxel, 5-FU and cisplatin for three cycles followed by concurrent weekly cisplatin and radiotherapy for responding or stable disease patients. Results: Forty-four patients were enrolled with male,female ratio of 33/44(75%) and 11/44(25%). Hypopharynx 16/44(36.36%) was the most common site followed by oral cavity 12/44(27.27%) and oropharynx 12/44(27.27%); 38/44(86.36%) patients could complete the planned treatment. Seven patients required dose reduction in ICT. As per the RECIST criteria, 16 patients had Complete Response (CR) and 15 had partial response (PR), 10 had stable disease (SD) and three had progressive disease (PD) after ICT. Thirty-eight patients received concomitant chemo radiotherapy (CCRT); 28/44 (66.63%) patients achieved CR, 10/44 (22.72 %) had PR. The main toxicity was mucositis 18/44 (40.90%) secondary to ICT. Grade III and IV hematological toxicity was seen in 16/44(36.36%), of which 6/44 (13.63%) had febrile neutropenia. Conclusions: Triple drug-based sequential therapy is tolerable in our context. In this trial from a single institute the results are very encouraging. |
| format | Article |
| id | doaj-art-fb3db280c3fb493787a58b6d388937c3 |
| institution | DOAJ |
| issn | 0971-5851 |
| language | English |
| publishDate | 2011-01-01 |
| publisher | Thieme Medical and Scientific Publishers Pvt. Ltd. |
| record_format | Article |
| series | Indian Journal of Medical and Paediatric Oncology |
| spelling | doaj-art-fb3db280c3fb493787a58b6d388937c32025-08-20T03:06:13ZengThieme Medical and Scientific Publishers Pvt. Ltd.Indian Journal of Medical and Paediatric Oncology0971-58512011-01-01322869110.4103/0971-5851.89781Sequential therapy (triple drug-based induction chemotherapy followed by concurrent chemoradiotherapy) in locally advanced inoperable head and neck cancer patients - Single institute experienceNaresh SomaniS GoyalR PasrichaN KhutetaP AgarwalA K GargH SinghalContext: India has a high incidence of head and neck squamous cell carcinoma (HNSCC) mostly presenting in advanced stage. In the majority of inoperable patients a combination of chemotherapy and radiotherapy (CRT) is considered as the treatment of choice. Adding induction chemotherapy (ICT) before CRT has shown to decrease systemic relapse. Incorporation of taxanes to the cisplatin and 5-FU-based ICT has shown increase in response rates. Aims: To evaluate the efficacy and toxicity of triple drug-based ICT followed by CCRT in locally advanced, inoperable HNSCC in the Indian context. Settings and Design: Prospective, non-controlled, observational study, a single-institute experience. Materials and Methods: Consecutive, locally advanced inoperable HNSCC patients were put on sequential therapy consisting of docetaxel, 5-FU and cisplatin for three cycles followed by concurrent weekly cisplatin and radiotherapy for responding or stable disease patients. Results: Forty-four patients were enrolled with male,female ratio of 33/44(75%) and 11/44(25%). Hypopharynx 16/44(36.36%) was the most common site followed by oral cavity 12/44(27.27%) and oropharynx 12/44(27.27%); 38/44(86.36%) patients could complete the planned treatment. Seven patients required dose reduction in ICT. As per the RECIST criteria, 16 patients had Complete Response (CR) and 15 had partial response (PR), 10 had stable disease (SD) and three had progressive disease (PD) after ICT. Thirty-eight patients received concomitant chemo radiotherapy (CCRT); 28/44 (66.63%) patients achieved CR, 10/44 (22.72 %) had PR. The main toxicity was mucositis 18/44 (40.90%) secondary to ICT. Grade III and IV hematological toxicity was seen in 16/44(36.36%), of which 6/44 (13.63%) had febrile neutropenia. Conclusions: Triple drug-based sequential therapy is tolerable in our context. In this trial from a single institute the results are very encouraging.http://www.ijmpo.org/article.asp?issn=0971-5851;year=2011;volume=32;issue=2;spage=86;epage=91;aulast=SomaniConcurrent chemoradiotherapyDocetaxel-Cisplatin-5FU regimeninduction chemotherapy |
| spellingShingle | Naresh Somani S Goyal R Pasricha N Khuteta P Agarwal A K Garg H Singhal Sequential therapy (triple drug-based induction chemotherapy followed by concurrent chemoradiotherapy) in locally advanced inoperable head and neck cancer patients - Single institute experience Indian Journal of Medical and Paediatric Oncology Concurrent chemoradiotherapy Docetaxel-Cisplatin-5FU regimen induction chemotherapy |
| title | Sequential therapy (triple drug-based induction chemotherapy followed by concurrent chemoradiotherapy) in locally advanced inoperable head and neck cancer patients - Single institute experience |
| title_full | Sequential therapy (triple drug-based induction chemotherapy followed by concurrent chemoradiotherapy) in locally advanced inoperable head and neck cancer patients - Single institute experience |
| title_fullStr | Sequential therapy (triple drug-based induction chemotherapy followed by concurrent chemoradiotherapy) in locally advanced inoperable head and neck cancer patients - Single institute experience |
| title_full_unstemmed | Sequential therapy (triple drug-based induction chemotherapy followed by concurrent chemoradiotherapy) in locally advanced inoperable head and neck cancer patients - Single institute experience |
| title_short | Sequential therapy (triple drug-based induction chemotherapy followed by concurrent chemoradiotherapy) in locally advanced inoperable head and neck cancer patients - Single institute experience |
| title_sort | sequential therapy triple drug based induction chemotherapy followed by concurrent chemoradiotherapy in locally advanced inoperable head and neck cancer patients single institute experience |
| topic | Concurrent chemoradiotherapy Docetaxel-Cisplatin-5FU regimen induction chemotherapy |
| url | http://www.ijmpo.org/article.asp?issn=0971-5851;year=2011;volume=32;issue=2;spage=86;epage=91;aulast=Somani |
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