Comparative study of quality of life, toxicity in weekly cisplatin vs three weekly cisplatin along with radiation in locally advanced head and neck malignancies

Abstract

Aim: This was a prospective two arm comparative study of quality of life, toxicity and response in patients of locally advanced head and neck cancers treated with concurrent chemoradiation with either three weekly or weekly Cisplatin. Materials and methods: The study was performed during 18 months period, 50 patients of locally advanced head and neck cancer were divided into two arms of 25 patients each. All the patients received conventional radiotherapy on linear accelerator with 6MV photons for a total dose of 66Gy, 2Gy per fraction for 33 fractions. Patients in Arm A received concurrent chemotherapy with three weekly Cisplatin at a dose of 100mg/m2 on day 1, 22 and 43. Patients in Arm B received concurrent chemotherapy with Cisplatin at a dose of 40mg/m2 given weekly. Results: All the patients completed the planned radiotherapy treatment except one patient in Arm A who died during RT. The mean cumulative dose was slightly higher in the weekly arm. RT delay and omission of chemotherapy was more common in the three weekly arm. Compliance to treatment was marginally better in the weekly arm. Response to chemoradiation was slightly better in arm B which was not statistically significant. Acute toxicities were slightly higher in the three weekly arm compared to the weekly arm but statistically insignificant. QOL scores were poorer for patients in the three weekly arm. Patients in the weekly arm reached baseline QOL scores compared to the three weekly arm. Conclusion: Patients who are nutritionally compromised and economically backward, radical radiation with weekly concurrent Cisplatin is a viable and an effective treatment option.