An observational comparative study of weekly and 3 weekly concurrent cisplatin-based chemoradiotherapy in locally advanced head-and-neck cancer in a peripheral medical college

Abstract

Introduction: Concurrent chemo-radiation with 100m/m2 three weekly cisplatin is the standard of care in inoperable locally advanced head and neck cancer (LAHNC) but is associated with significant toxicities. The objective of the study was to assess the tumour response and toxicities in the three weekly and lower dose weekly cisplatin based chemo radiation regimens. Methodology: The prospective study was conducted in a peripheral medical college from May 2020 to July 2021. One hundred and twelve patients were recruited, 56 in each arm. The three weekly arms received 100mg/m2 cisplatin whereas the weekly arm received weekly 40mg/m2 cisplatin both concurrently with radiation dose of 70 Gray in 35 fractions over seven weeks. One-way analysis of variance was used to compare means of three or more samples for numerical data. Unpaired proportions were compared by Chi-square test or Fischer's exact test. Results: One hundred patients completed the study and were evaluable, 42 in the three weekly arm and 48 in the weekly arm. Disease response at 12 months in the two arms was not statistically significant. The toxicities were lower in weekly arm as compared to three weekly arms but were not statistically significant. Conclusion: The study confirms that weekly concurrent cisplatin is an acceptable alternative treatment to three weekly regimens in inoperable LAHNC. The lower dose weekly concurrent cisplatin regime is better tolerated in our patients with increased treatment compliance.