CONCURRENT CHEMORADIATION IN LOCALLY ADVANCED HEAD AND NECK CANCER --CAPECITABINE & CISPLATIN Vs CISPLATIN- A RANDOMISED PROSPECTIVE COMPARATIVE STUDY

BACKGROUND: Aim of my study is to compare the response and toxicity profile of squamous cell carcinoma of Head & Neck(SCHNC) patients when in concurrent chemoradiation( CTRT)  Capectabine is combined with cisplatin vs cisplatin alone.

METHODS: 55 patients of stage III/IV nonmetastatic SCHNC patients were either treated with CTRT with Cisplatin & Capecitabine arm(Arm A, n=29), or with Cisplatin (Arm B, n=26). In both the arm Radiotherapy dose was 66 - 70 Gy in conventional fractionation. Response was assessed by RECIST criteria after 6 wks of completion of treatment and acute toxicities by the RTOG/EORTC guideline. Comparison was done by Chi-Square test, Fisher’s Exact test & Independent T test using SPSS Software.

RESULTS: It was seen that 65.5% patient in Arm A & 34.6% patients in Arm B [p=.022] showed complete response. The grade 2/3 acute toxicities  of Skin, Mucous Membrane ,Salivary gland  in Arm A & B were 72.4% & 30.8% [p=.005]; 69%&15.4% [p<.001]; 58.6% & 11.5% [p<.001] respectively. Significant acute grade 2/3 toxicities of Esopagus+pharynx [p<.001],Larynx[p=.001] &Upper GI tract[p=.001] were also present in the patients of ArmA.

COLCLUSIONS: In locally advanced nonmetastatic SCHNC during CTRT combining Capecitabine with Cisplatin results in significant response benefit  but  toxicities are more.