UNRESECTABLE HEAD AND NECK CARCINOMAS

CONCOMITANT CHEMO-RADIOTHERAPY WITH CISPLATIN AND 5-FLOUROURACIL

Abstract

Introduction: Cancers of the head and neck are estimated to be the most prevalent cancers in the world. Data from various cancer centers of Pakistan reveal that epithelial head and neck cancer is one of the most frequent cancers varying from 12 to 25% of the total new patients seen
annually. Objectives: To see the effect of concomitant chemo-radiotherapy on the survival of patient, to assess the toxicity of different treatment arms and the effect of age, sex and bulk or tumour on survival and compare the literature. Setting: Radiotherapy Department, Nishtar Hospital, Multan. Duration: 2 years. Material and Methods: Sample Size: 200 patients. Results: Out of 130 patients, 83 were males and the
remaining 47 were females. The male to female ratio being 1.8:1. The mean age of the patients included in the study was 52 years, range being 22-80 years. The patients of head and neck cancer in the trial had different sites of involvement. In the trial the patients presented with various symptoms such as pain, swelling, ulcer, bleeding, dysphagia, dyspnea, hoarseness of voice and nasal obstruction etc. No patient had early stage disease. All the patients in the trial had the experience of nausea and vomiting, it was more marked in patients having radiotherapy; either alone or in concomitant with chemotherapy. The patients having concomitant chemo-radiotherapy i.e. group-C also had diarrhoea as a side effect. The effect on the liver function test was more pronounced in patients of group-A. The renal function was seen to alter more in patients receiving chemotherapy with cisplatin, whether as induction or as a concomitant to radiotherapy. Conclusion: Concomitant chemo-radiotherapy in locally advanced, unresectable head and neck carcinoma is statistically superior to induction chemotherapy followed by radiotherapy and the standard radiotherapy alone.