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Synchronous Chemoradiotherapy in Patients with Stage III and IV Head and Neck Cancer: Comparing Cisplatin with Capecitabine

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DOI: 10.4236/jct.2012.36135    4,056 Downloads   6,156 Views   Citations

ABSTRACT

Purpose: To evaluate the efficacy of concurrent intravenous cisplatin versus oral capecitabine with radical radiotherapy in locally advanced squamous cell carcinoma of the head and neck. Materials and methods: Between January 2007 and December 2009, 60 patients with stage III/IV head and neck squamous cell carcinoma (0 to 1 performance status) were enrolled into this study. Thirty cases are given cisplatin 30 mg/m2 IV infusion weekly for 6 weeks with conventional radiotherapy. The remaining thirty cases are given oral capecitabine 500 mg/m2 twice daily, continuously for 28 - 35 days with conventional radiotherapy also. The radiotherapy dose was 4600 cGy in 20 fractions over 4 weeks to primary and neck nodes followed by boost to primary site and any residual disease 1500 - 2000 cGy in 6 to 8 fractions. Results: The median age was 53 (range 25 - 71) years; 10 cases had stage III disease, 36 cases IVa disease and 14 cases IVb disease. Seventy-three percent of patients completed the course of capecitabine and 80% completed prescribed cisplatin. There were no treatment-related deaths, grade 4 haematological toxicity or grade 3 renal toxicity in either arm. The complete response rate at 3 months was 77% (23/30 patients) in the capecitabine group and 60% (18/30) in the cisplatin group. Relapse occurred in 10/30 (33%) patients by 2 years in the capecitabine group and in 12/30 (40%) in the cisplatin group. On analysis of survival data, the median follow-up period was 35 ± 15 months for overall survival and 33 ± 10 months for disease free survival. The overall survival, and disease-free survival rates at 2 years were 67%, and 85%, respectively for the capecitabine group versus 60% and 73% for the cisplatin group. Conclusion: Synchronous chemo-radiotherapy with capecitabine was found to be very effective, with excellent response, local control and 3-year cancer-specific survival rates.

Conflicts of Interest

The authors declare no conflicts of interest.

Cite this paper

S. Raafat, E. Habib and A. Maurice, "Synchronous Chemoradiotherapy in Patients with Stage III and IV Head and Neck Cancer: Comparing Cisplatin with Capecitabine," Journal of Cancer Therapy, Vol. 3 No. 6, 2012, pp. 1045-1051. doi: 10.4236/jct.2012.36135.

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