COMPARATIVE STUDY BETWEEN THREE WEEKLY CISPLATIN VERSUS WEEKLY CISPLATIN IN LOCALLY ADVANCED HEAD & NECK CANCER

Background: The head and neck cancers rank among the top 10 cancers globally. A huger population with newly diagnosed cancers is registered in India every year. Of these oral cancers are the most common in India. Surgery forms the mainstay of treatment. Concurrent chemoradiotherapy has shown better results in comparison to surgery alone in advanced cases. Cisplatin is the best radiosensitizer and has been accepted as the standard reference regimen. The present study was carried out to compare two different dosing schedules of cisplatin in terms of tolerance and response to the treatment. Methodology: The present prospective, comparative study was carried out in the Department of Radiation Oncology, Government Cancer Hospital, Indore. 60 patients with local advanced head and neck cancers were included, divided into two arms. Arm-A with 30 patients received radical radiotherapy with cisplatin given every week during the radiotherapy sessions, while Arm-B patients received radical radiotherapy with concurrent cisplatin on day 1, 22 and 43. The RECIST 1.1 criteria was used for nding out the response. Proportional comparison was done using Pearson Chisquare test. Results: There was a male preponderance in both the arms. 41.7% had moderately and 31.7% had poorly differentiated histological carcinoma grades. 55% had proliferative growth. 66.7% were in stage III and 33.3% were in stage IV disease. 60% in Arm-A and 70% in Arm-B had complete response. 10% in Arm-A and 3% in Arm-B had progression of the disease. Mucositis, dermatitis, xerostomia, trismus, dysphagia, anemia, thrombocytopenia, etc. all were comparable between the two arms (p>0.05). Conclusion: Our study found that cisplatin if given on day 1, 22 and 43 concurrently with radiation therapy has better outcome with lower incidence of disease progression.