Chemoradiation in Advanced Head and Neck Cancers: A Comparison of two Radiosensitizers, Paclitaxel and Cisplatin

  • Sohit Paul Kanotra
  • Sonika Kanotra
  • Ashutosh Gupta
  • J. Paul
Original Article

DOI: 10.1007/s12070-011-0263-1

Cite this article as:
Kanotra, S.P., Kanotra, S., Gupta, A. et al. Indian J Otolaryngol Head Neck Surg (2011) 63: 229. doi:10.1007/s12070-011-0263-1

Abstract

To compare the locoregional control rates, survival outcome and toxicity profiles between two groups of patients of squamous cell carcinoma (SCC) of Head and Neck (Stage III & IV) receiving concomitant chemo-radiotherapy with Paclitaxel and Cisplatin. A prospective study was done on 94 previously untreated patients of histopathologically proved squamous cell carcinoma of head and neck region-AJCC stage III & IV (T3 & T4 with N0 -N3, M0) treated with concomitant chemoradiation. The patients were divided into two groups. Group A (44 patients) received concomitant chemotherapy (C.T.) with Paclitaxel 40 mgm/m2 while Group B (50 patients) received concomitant chemotherapy with Cisplatin 40 mgm/m2. All the patients in both the groups responded. In Group A (Paclitaxel + R.T.), complete response was seen in 72.7% and partial response in 27.3%. In Group B (Cisplatin +R.T.) complete response was seen in 52% and partial in 48%. At one year follow up, the locoregional control rate (LRC) in Group A was significantly higher as compared to that in Group B (65.9 vs. 46%, P<0.05) while there was no difference in the disease free survival (DFS) and the overall survival (OS). A 3 year estimate of the LRC, DFS and OS using Kaplan Meier Estimator revealed no difference in the LRC, DFS and OS between the 2 groups. There was a higher incidence of skin and mucosal toxicity with Paclitaxel while the gastro-intestinal and hematological toxicity was more with Cisplatin. No significant chronic toxicity except xerostomia was observed in either group. Paclitaxel has better complete response and locoregional control rates at 1 year as compared to cisplatin. However, there is no difference in the estimated 3 year rates of locoregional control, disease free survival and overall survival between the 2 groups.

Keywords

Chemoradiation Paclitaxel Cisplatin 

Copyright information

© Association of Otolaryngologists of India 2011

Authors and Affiliations

  • Sohit Paul Kanotra
    • 1
  • Sonika Kanotra
    • 2
  • Ashutosh Gupta
    • 3
  • J. Paul
    • 4
  1. 1.Department of ENTSt. Luke’s Roosevelt Hospital CentreNew YorkUSA
  2. 2.Government Medical CollegeJammuIndia
  3. 3.Department of Radiation OncologyGovernment Medical CollegeJammuIndia
  4. 4.Department of E.N.TASCOMSJammuIndia

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