Comparison of daily low dose cisplatin versus weekly cisplatin concurrently with radiotherapy during head and neck cancer

Abstract

Introduction : Head and neck cancers can arise in the oral cavity, pharynx, larynx, nasal cavity, paranasal sinuses, thyroid, and salivary glands and include a variety of histopathologic tumours. Squamous cell cancer (SCC) is the most common pathological type of head and neck cancer. Materials and Methods: This is prospective, Observational and comparative study. The diagnosis of untreated squamous cell carcinoma of the head and neck region, i.e., oral cavity, oropharynx, hypopharynx, or larynx in advanced stage III, IVA or IVB SCCHN was confirmed by a radiation oncologist prior to the initiation of the treatment. Results : Patients were considered to comply with radiation treatment if they completed 70 Gy within 45 days. Chemotherapy compliance (six cycles in weekly or 28-30 cycles in daily cisplatin) were 63% and 73%, respectively. The primary reason for noncompliance toward chemotherapy (37% vs. 27% in weekly vs. daily Cisplatin studies, respectively) was due to the development of excessive toxicity. This also included those who left treatment midway (due to any reason) or died during therapy. Conclusions : Therefore, if an intensified treatment protocol has to be used, i.e. modest acceleration along with either "weekly" or "daily" cisplatin, both can be used, provided patients are selected properly and due attention is paid to timely and adequate supportive care.