Concurrent Chemoradiation with Weekly Cisplatin for the Treatment of Head and Neck Cancers: an Institutional Study on Acute Toxicity and Response to Treatment

Background: Concurrent chemoradiation with three weekly high dose cisplatin is the non-surgical standard ofcare for the treatment of locally advanced head and neck cancers. Although this treatment regime is efficacious,it has high acute toxicity, which leads not only to increased treatment cost, but also to increased overall treatmenttime. Hence, the current study was undertaken to evaluate the acute toxicity and tumor response in head andneck cancer patients treated with concurrent chemoradiation using 40 mg/m2 weekly cisplatin, which has beenour institutional practice. Materials and
Methods: This single institution retrospective study included data for287 head and neck cancer patients treated with concurrent chemoradiation from 2012 to 2014.
Results: Themean age of the patients was 48.8 years. The most common site of involvement was oral cavity. Most of the studypatients presented with advanced stage disease. The mean overall treatment time was 56.9 days. Some 67.2%had overall complete response to treatment as documented till 90 days from the start of treatment. Accordingto the Radiation Therapy Oncology Group (RTOG) acute radiation morbidity scoring criteria, mucositis wasseen in 95.1% of the patients. Dermatitis and emesis were observed in 81.9% and 98.6%, respectively. Regardinghaematological toxicity, 48.8% and 29.6% suffered from anaemia and leukopenia, respectively, during treatment.Acute kidney injury was assessed using the Common Terminology Criteria for Adverse Events (CTCAE), andwas found in 18.8% of the patients.
Conclusions: Concurrent chemoradiotherapy with weekly cisplatin is aneffective treatment regime for head and neck cancers with reasonable toxicity which can be used in developingcountries, where cost of treatment is so important.