Interim Analysis: Combined Modality Treatment in Advanced Head and Neck Cancer

Aim: Optimizing the locorcgional control in locally advanced head and neck cancer by concurrent chemoradiation using the concomitant boost subtype of accelerated fractionation radiotherapy. Also assessment of the safety profile of this combined modality. Patients and Methods: Twenty-three evaluable patients with locally advanced head and neck cancer were recruited. Their median age was 53 and performance status 1-2 (WHO). The primary was located in the larynx in 11 cases (48%) the nasopharynx 8 cases (35%) the hypopharynx 3 cases (13%) and the oropharynx 1 case(4%). T3-4 was seen in 20 cases (88%) and N2-3 in 7 cases (30%). The median total dose of radiation was 71.5Gy with median concomitant boost of 10Gy. The biologic effective dose with time correction in this study was 59.2Gy 10. Concurrent Cisplatinum was prescribed in a dose of 80mg/m² q 3 weeks. The recorded relative dose intensity of Cisplatin was 0.75. Results: The commonest recorded grade 314 (WHO) toxicity was mucositis (dysphagia) in 8 cases (35%) followed by vomiting in 7 cases (30%) and asthenia in 5 cases (22%). However all case showed objective response to treatment with 15 cases (65%) in complete response sustained to the end of the study. Conclusion: Our treatment is fairly tolerated by the patients included in this study with satisfactory locoregional control of their advanced disease.