Conventional chemoradiation vs. induction chemotherapy followed by conventional chemoradiation for locally advanced head and neck cancer: A prospective, randomized study

Rana,Amit; Rana,Priyanka; Gupta,Manoj; Seam,Rajeev; Gupta,Manish

doi:10.3892/wasj.2020.65

Conventional chemoradiation vs. induction chemotherapy followed by conventional chemoradiation for locally advanced head and neck cancer: A prospective, randomized study

Authors:
- Amit Rana
- Priyanka Rana
- Manoj Gupta
- Rajeev Seam
- Manish Gupta
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Affiliations: Department of Radiotherapy, Regional Cancer Centre, Indira Gandhi Medical College, Shimla, Himachal Pradesh 171 001, India, Directorate of Health Services, Shimla, Himachal Pradesh 171 009, India, Department of Radiotherapy, All India Institute of Medical Sciences, Rishikesh, Uttarakhand 249 203, India, Department of Radiotherapy, Maharishi Markandeshwar University, Ambala, Haryana 133 203, India
Published online on: August 27, 2020 https://doi.org/10.3892/wasj.2020.65
Article Number: 24
Copyright: © Rana et al. This is an open access article distributed under the terms of Creative Commons Attribution License.

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Abstract

The standard‑of‑care in locally advanced squamous cell carcinoma of the head and neck (LA SCCHN) remains concurrent chemoradiotherapy. The present study compared the disease response and safety profile of induction chemotherapy followed by concomitant chemoradiotherapy (CRT) vs. CRT alone in patients with LA SCCHN. The present prospective randomized study was conducted between July, 2014 and July, 2015 on 52 patients with SCCHN of the oropharynx, hypopharynx and larynx. Patients were randomly divided into the induction chemotherapy [docetaxel, cisplatin and 5‑FU (TPF)] followed by CRT arm (TPF + CRT arm, n=25) or the CRT alone arm (CRT arm, n=27). The disease response, and acute and late toxicities were assessed. At the first follow‑up (6 weeks), the overall response rate (ORR) was 82.6% for the TPF + CRT arm and 72% for the CRT arm; the difference was not significant. In addition, no statistically significant differences were observed in the nodal response between the treatment arms. Acute toxicities were significantly higher in the TPF + CRT arm, with respect to mucositis and hematological toxicities. No differences were observed in late‑onset toxicities observed following 3 months of radiotherapy. Triple drug‑based sequential therapy was tolerable in the population in the present study and may thus hold promise for the treatment of SCCHN; however, larger prospective studies are required to confirm these results.

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