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Original Research 


A comparative study of two schedules of concomitant Chemo-radiation with Cisplatin in locally advanced Head and Neck Cancer in Southern Rajasthan of India

Vikram Singh Rajpurohit, Narendra Kumar Rathore, Atul Verma, Suresh Kumar Dangayach, Arvind Kumar Shukla and Pawan Kumar Jangid.

Abstract
Introduction: Head and neck cancer is the most common cancer in south-central Asia. It constitutes about 17.7% of all cancers occurring in India. Majority of them present with locoregionally advanced stage. Concurrent chemo-radiotherapy (CCRT) is recognized worldwide as a standard treatment option for locally advanced disease not amenable to surgical resection.
Aims: To compare the differences in acute toxicities and response rate between two schedules (weekly and 3-weekly divided dose cisplatin-based) of concomitant chemo-radiation (CCRT) regimens in locally advanced head and neck squamous cell carcinoma (LHNSCC).
Methods and Material: Total of 62 eligible patients of LHNSCC who satisfying the eligibility criteria were included in this study. After pre-treatment evaluation, patients were sequentially randomized into two arms: 31 patients were taken in each arm, Arm-A (weekly concurrent cisplatin group) and Arm- B (three weekly divided dose concurrent cisplatin groups). One patient in each arm dropped out due to poor compliance. In both the arms, radiotherapy was delivered to a dose of 66-70 Gy with a telecobalt machine as a conventional fractionation schedule. The primary endpoints of the study were to know the disease response and assessment of acute toxicity profile in both arms.
Results: Among the in-field toxicity, we found mucositis as the commonest toxicity in both arms. Incidence of Grade-III (33.33% vs 40%) & Grade-IV mucositis (6.66% vs 10%), acute gastrointestinal toxicity (Nausea- 33.33% vs 46.33% & vomiting- 13.33% vs 20%), and acute renal toxicity (16.66% vs 10%) were found to be slightly higher in 3-weekly arm compared to weekly arm. Our study showed that higher the incidence of neutropenia grade-I (23.33% VS 16.66%) and acute skin reaction (40% vs 33.33%) occurred in the weekly CCRT arm compared to the 3-weekly CCRT arm. In view of treatment compliance and response rate, our study showed 3-weekly arm have a higher compliance rate of scheduled chemotherapy cycles and a higher response rate (CR=80% vs 70%) compared to the weekly arm.
Conclusions: The present study concluded that the three weekly divided dose concurrent cisplatin arms having a slightly better response rate with a slight increase in mucosal toxicity while the weekly concurrent cisplatin arm having a reduced requirement of feeding tube placement, colony-stimulating factor and hospitalization for supportive care.

Key words: Radiotherapy, Toxicity, Response


 
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How to Cite this Article
Pubmed Style

Rajpurohit VS, Rathore NK, Verma A, Dangayach SK, . A comparative study of two schedules of concomitant Chemo-radiation with Cisplatin in locally advanced Head and Neck Cancer in Southern Rajasthan of India. doi:10.5455/IJMRCR.locally-advanced-Head-Neck-Cancer-india-cisplatin


Web Style

Rajpurohit VS, Rathore NK, Verma A, Dangayach SK, . A comparative study of two schedules of concomitant Chemo-radiation with Cisplatin in locally advanced Head and Neck Cancer in Southern Rajasthan of India. http://www.mdpub.net/?mno=6255 [Access: March 09, 2021]. doi:10.5455/IJMRCR.locally-advanced-Head-Neck-Cancer-india-cisplatin


AMA (American Medical Association) Style

Rajpurohit VS, Rathore NK, Verma A, Dangayach SK, . A comparative study of two schedules of concomitant Chemo-radiation with Cisplatin in locally advanced Head and Neck Cancer in Southern Rajasthan of India. doi:10.5455/IJMRCR.locally-advanced-Head-Neck-Cancer-india-cisplatin



Vancouver/ICMJE Style

Rajpurohit VS, Rathore NK, Verma A, Dangayach SK, . A comparative study of two schedules of concomitant Chemo-radiation with Cisplatin in locally advanced Head and Neck Cancer in Southern Rajasthan of India. doi:10.5455/IJMRCR.locally-advanced-Head-Neck-Cancer-india-cisplatin



Harvard Style

Rajpurohit, V. S., Rathore, . N. K., Verma, . A., Dangayach, . S. K. & (2021) A comparative study of two schedules of concomitant Chemo-radiation with Cisplatin in locally advanced Head and Neck Cancer in Southern Rajasthan of India. doi:10.5455/IJMRCR.locally-advanced-Head-Neck-Cancer-india-cisplatin



Turabian Style

Rajpurohit, Vikram Singh, Narendra Kumar Rathore, Atul Verma, Suresh Kumar Dangayach, and Arvind Kumar Shukla and Pawan Kumar Jangid. 2021. A comparative study of two schedules of concomitant Chemo-radiation with Cisplatin in locally advanced Head and Neck Cancer in Southern Rajasthan of India. doi:10.5455/IJMRCR.locally-advanced-Head-Neck-Cancer-india-cisplatin



Chicago Style

Rajpurohit, Vikram Singh, Narendra Kumar Rathore, Atul Verma, Suresh Kumar Dangayach, and Arvind Kumar Shukla and Pawan Kumar Jangid. "A comparative study of two schedules of concomitant Chemo-radiation with Cisplatin in locally advanced Head and Neck Cancer in Southern Rajasthan of India." doi:10.5455/IJMRCR.locally-advanced-Head-Neck-Cancer-india-cisplatin



MLA (The Modern Language Association) Style

Rajpurohit, Vikram Singh, Narendra Kumar Rathore, Atul Verma, Suresh Kumar Dangayach, and Arvind Kumar Shukla and Pawan Kumar Jangid. "A comparative study of two schedules of concomitant Chemo-radiation with Cisplatin in locally advanced Head and Neck Cancer in Southern Rajasthan of India." doi:10.5455/IJMRCR.locally-advanced-Head-Neck-Cancer-india-cisplatin



APA (American Psychological Association) Style

Rajpurohit, V. S., Rathore, . N. K., Verma, . A., Dangayach, . S. K. & (2021) A comparative study of two schedules of concomitant Chemo-radiation with Cisplatin in locally advanced Head and Neck Cancer in Southern Rajasthan of India. doi:10.5455/IJMRCR.locally-advanced-Head-Neck-Cancer-india-cisplatin