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Chemoradiotherapy for advanced head and neck cancer - Analysis of a prospective, randomized trial
Objective:
To study the efficacy of neo-adjuvant chemotherapy followed by radiotherapy in advanced head and neck cancer.
Study Design:
Randomised, prospective study.
Setting:
Tertiary academic referral center.
Patients:
One hundred and eighty patients of advanced head and neck squamous cell carcinoma.
Intervention:
PATIENTS were randomized into two arms. The study arm (CT-RT arm) received 3 cycles of anterior chemotherapy with Inj. Cisplatin 100 mg/m(2) on D(1) and Inj 5F.U. 700 mg/m(2) on D(1)-D(4) at an interval of 21 days, followed by external radiation. The control arm (RT arm) received external radiotherapy only. The dose of Radiotherapy was 64 to 68 Gy in conventional fractionation.
Results:
PATIENTS of CT-RT showed better tumour control locally than patients who received only RT. Toxicities were commoner in CT-RT arm but they were manageable. 5 year survival is higher in the CT-RT arm (21% vs 16%; p value> 0.05).
Conclusion:
Anterior chemotherapy with Cisplatin and 5F.U. is associated with good clinical response which is translated into increased survival along with acceptable toxicities.
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