Kulsoom Begum, Syeda Uzma Naqvi, Akhtar Ahmed, Syed Amir Maqbool.
Efficiency of Cisplatin Based Concurrent Chemoradiation in Stages III & IV Head & Neck Squamous Cell Carcinoma.
J Dow Uni Health Sci Jan ;10(2):59-64.

Objective: To determine the response of cisplatin based concurrent chemoradiation in stages III and IV head & neck squamous cell cancer and to evaluate frequency of common toxicities. Introduction: Almost 70% of head and neck cancer patients present with locally advanced disease (stage III and IV). Concurrent chemo-radiotherapy is the current standard treatment. Cytotoxic cisplatin is the treatment of choice for concomitant chemoradiotherapy. Cisplatin acts as a radiation sensitizer and advances the antitumor efficacy when combined with radiotherapy. Likewise all chemotherapeutic agents also show side effects including mucositis, dermatitis, nausea & diarrhea. Materials & Methods: A descriptive study conducted in Department of Radiotherapy, Karachi Institute of Radiotherapy and Nuclear Medicine from 2010 to 2011. Fractions with 2 Gy per fraction were completed in 7 weeks. Sample size of 85 enrolled. Total dose of radiotherapy was 66 Gy in 33 fractions. Cisplatin of 100 mg /m² on day 1, 22 and 43 were given. Treatment response was determined radiologically at four weeks. Toxicity was assessed weekly during treatment. Results: Mean age was 55.4 (±10.5) years with Male to Female ratio was 1.3: 1. Thirty (41.1%) patients had achieved complete response (CR), 36 (49.3%) patients had partial response (PR). Significant response rate was 90.4%. p-value was siginficant <0.05. Most common toxic effects were mucositis 72.6%, vomiting 68.5%, moderate dermatitis 64.4% followed by mild diarrhea 60.3% and dry mouth 54.8%. Overall response of cisplatin was good. Conclusion: A significant response of cisplatin based chemoradiation achieved. Mucositis was found the most common toxic effect.

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