Vishnu Priya Munagapati1 , Paul Alankaar2 , G.J. Benjamin3
BACKGROUND As most cases of head and neck cancer are locally advanced, i.e., stage III and IV, it may be useful to compare induction chemotherapy policies accompanied by simultaneous chemoradiation with concomitant chemoradiation alone, in terms of tumour response and toxicity profile in these cases. That's why this study was undertaken. We wanted to evaluate induction chemotherapy accompanied by chemoradiation in terms of local regulation as opposed to chemoradiation alone in locally advanced Head and Neck Cancers. METHODS This is a prospective comparative study. Study was done between July 2017 and July 2019, with Arm A (Test Group) & Arm B (Control group). Forty patients of locally advanced Head and Neck cancer from the outpatient department, selected for treatment, were included in the study, with 20 in each arm. RESULTS Reduction in tumour size after treatment was compared in both the groups with RECIST (Response Evaluation Criteria in Solid Tumours) 1.1. Induction chemotherapy caused significant reduction in tumour size but had more toxicities which were manageable. When compared to conventional chemoradiation, the induction chemo group did not show statistically significant benefit. Response was better in patients with high nodal volume as some of the cases showed good response in the nodal volume irrespective of response of the primary. CONCLUSIONS This study emphasizes the role of induction chemotherapy in select patients with advanced disease, especially in high volume, where majority of cases (more than 80 %) are stage III or IV and above. Hence, patient selection is the key to outweigh the risk involved.
