कैंसर विज्ञान एवं चिकित्सा

Low Dose Weekly Paclitaxel Versus Low Dose Weekly Cisplatin with Concomitant Radiation in Locally Advanced Head and Neck Cancers

Abstract

Rasha Hamdy Hamed and Eman Elzahaf

Purpose: The purpose of this prospective phase III study was to compare the role of concomitant chemoradiation using paclitaxel versus cisplatin in locally advanced head and neck cancers. Patients and methods: 52 patients were randomly assigned to one of the two concomitant chemoradiation arms: arm I (n=26) and arm II (n= 26) who received injection of paclitaxel 20 mg/m2 I/V 1 hour infusion before radiation, repeated weekly for 6 cycles, and cisplatin 30 mg/m2 I/V 1 hour infusion before radiation, repeated weekly for 6 cycles, respectively. The planned radiotherapy dose was 66-70 Gy, 1.8-2 Gy/day, 5#/Week in 6-7 weeks. Results: Response rates were 76 and 69.2% in arm I and arm II, respectively (P = 0.53). The hematological toxicity was generally mild. On the contrary, non-hematologic toxicities were severe. Grade III mucositis occurred in 32% in arm I and in 23.1% in arm II (P = 0.04). Moreover, grade III dermatitis were encountered in 28% in arm I and 11.5% in arm II (P = 0.03). The 2-year local-regional control figures were 60 and 57.1% in arm I and arm II, respectively(P=0.52) ; however the 2-year progression-free survival figures were 36.8 and 33.3% in arm I and arm II, respectively(P=0.43), while the 2-year overall survival figures were 56 and 50% in arm I and arm II, respectively (P = 0.68). Conclusion: Both concomitant chemoradiotherapy regimens were easily given in the outpatient clinic. The regimen based on paclitaxel was more effective; however, the difference was insignificant.