Induction chemotherapy followed by concomitant chemo-radiotherapy in advanced head and neck cancer: Center experience

Objective: Retrospective assessment of response rate, clinical outcome and toxicity in head and neck cancer patients treated with induction chemotherapy followed by concomitant chemo radiotherapy. Patients and Methods: From April 2011 till March 2014, we collected the data for patients with locally advanced head and neck cancer who were treatment with 3 cycles of induction chemotherapy using cisplatin and fluorouracil (5-FU), (PF) followed by radiation therapy for a total radiation dose of 66 Gy and concomitant cisplatin at a dose of 100 mg/m2 on days 1, 22, and 43 of radiotherapy. Results: Twenty patients were included more than 90% had stage III disease and only 20 % had laryngeal cancer. Eighty percent of patients had performance status 0 and 25% of patients had >5% weight loss at the start of treatment. The response to PF was complete response(CR) in three patients (15 %) while 40 % (8 patients) achieved partial response (PR). Nine patients (45%) had stable disease (SD) and no patients had progressive disease (PD). By the end of concurrent chemo-irradiation, seven patients (35%) had CR, 3 patients (15%) had PR. Four patients (20%) had stable disease (SD) and 6 patients (30%) had PD. At a median follow-up time of 12.5 months (range 1-23), nine patients (45%) were still alive and seven patients of living (35% of all patients and 77.77% of living) were progression-free. The median duration of response was 10 months (range 0-20), the median progression-free survival was 9.5 months (range 0-25), the median overall survival time was 10 months (range 1-23). The toxicity was significant and consisted mainly of mucositis and, to a lesser extent, neutropenia/thrombocytopenia. Conclusion: In our center experience the induction chemotherapy and chemo-radiotherapy program has been found moderately active but with apparent significant toxic profile.