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Category: Volume 10 Issue 04 April 2022
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Title: Response and Toxicity Outcomes of Induction Chemotherapy Followed by Concurrent Chemoradiotherapy Compared with Concurrent Chemoradiotherapy alone in Locally Advanced Oropharyngeal Squamous Cell Carcinoma

Authors: Dr S.M. Ashiqur Rahman, Dr Md. Zillur Rahman Bhuiyan, Dr Maj. Md. Tariq Hasan, Dr Shorav Biswas, Dr Zenia Sikder, Dr Afsana Sharmin Anika

 DOI: https://dx.doi.org/10.18535/jmscr/v10i4.08

Abstract

Treatment of oropharyngeal carcinomas significantly impact patient's quality of life for critical function in speech and swallowing. Though concurrent chemoradiotherapy (CCRT) is the established standard of care for inoperable disease, induction chemotherapy (IC) is still being investigated in attempt to decrease the chance of distant metastases and improve loco-regional control. This study was carried out among 82 patients of inoperable locally advanced OPSCC (stage III to IVB) from November, 2020 to October, 2021 who fulfilled the inclusion and exclusion criteria and distributed into two treatment arms by purposive sampling in BSMMU, NICRH and DHL. Arm A received IC with docetaxel / cisplatin / 5 fluorouracil (TPF) schedule followed by CCRT and Arm B received CCRT alone both with 3DCRT, 66Gy in 2Gy daily fraction, 5 fractions per week. Final responses were evaluated at 24 weeks after the treatment. In Arm A, 29 (70.7%) patients and in Arm B, 18 (43.9%) patients showed complete response (CR). Acute hematologic and non-hematologic toxic effects during chemoradiotherapy were almost similar in the two arms. In conclusion, Induction chemotherapy followed by concurrent chemoradiotherapy is more effective than concurrent chemoradiotherapy alone in terms of loco-regional control in inoperable locally advanced oropharyngeal squamous cell carcinoma with acceptable toxicities.

Keywords: Induction chemotherapy, Concurrent chemoradiotherapy, oropharyngeal squamous cell carcinoma.

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Corresponding Author

Dr S.M. Ashiqur Rahman

Department of Clinical Oncology, Bangabandhu Sheikh Mujib Medical University (BSMMU), Dhaka, Bangladesh