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Induction Chemotherapy in Unresectable or Locally Advanced Head and Neck Squamous Cell Cancer: A Single Center Retrospective Experience

Vinayak V Maka, Associate Professor, Department of Medical oncology, M S Ramaiah Medical College, MSRIT post, Bangalore, Karnataka 560054, India. , Vinayak V. Maka1 , Kirthi Koushik2

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Indian Journal of Cancer Education and Research 6(2):p 135-141, July-Dec 2018. | DOI: DOI: http://dx.doi.org/10.21088/ijcer.2321.9815.6218.3

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Abstract

  Head and Neck Squamous Cell Carcinoma (HNSCC), have an unsatisfactory prognosis despite intensive local treatment. Single institution retrospective study of 60 patients, who were treated with induction chemotherapy followed by Concurrent chemo radiation for period between January 2012 to December 2012 to understand utility of Induction Chemotherapy (IC), response rates and outcome analysis of patients with locally advanced and non-metastatic HNSCC. 38 out of 60 patients (63.3%) received all 3 planned IC cycles and 15 (25%) patients completed only 2 out of 3 cycles and rest of patients defaulted during course of chemotherapy. Only 32 patients had clinical benefit (CBR 38%), 12 patients had CR (20%), 11 patients had PR (18%), and SD in 9 patients (15%) on IC therapy. 20 (33.33%) patients received subsequent radiation treatment following IC. Among 20 patients who received subsequent radiation treatment, 17 were treated with radical intent and 3 with  palliative intent. Remaining 40 (66.67%) failed to receive any further treatment. At last only 12 out of 17 patients received concurrent chemo radiotherapy following Induction chemotherapy and five disease free survival  rate was 46%. Induction chemotherapy is almost always associated with poor patient compliance to planned definitive treatment in developing country. Innovative and individualized approach for patient compliance is required. Periodic assessment of induction chemotherapy response, target therapies and early initiation of radiation therapy in non-responder should be the cornerstone of future strategy. 

Keywords: Concurrent Chemoradiation; Induction Chemotherapy; Locally Advanced Head and Neck Squamous Cell Cancer; Treatment Outcomes; Response Rate.

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DOI: DOI: http://dx.doi.org/10.21088/ijcer.2321.9815.6218.3

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