Concurrent Chemoradiotherapy with Hydroxyurea vs Cisplatin in locally advanced Head and Neck Cancers
Journal Title: Journal of Medical Science And clinical Research - Year 2018, Vol 6, Issue 9
Abstract
Background: Head and neck cancers constitute 6% of cancers worldwide. The management requires a multidisciplinary approach. Concomitant CRT with cisplatin is the standard approach for locally advanced head and neck cancers. In developing countries, poor built and general condition of patients may allow use of other radio sensitizers like Hydroxyurea to enhance the effect of radiation. Methods: Squamous cell carcinoma of stage III, IVA and IVB of oropharynx, hypopharynx and larynx were studied for one year. 90 patients were randomized in control and study arm, 45 patients in each arm. Total dose of radiation was 66Gy/33#/6 ½ weeks from Monday to Friday in both the arms with inj. Cisplatin 30mg/m2 i.v. infusion weekly in control arm and oral Hydroxyurea25mg/kg approx. 16-18hours before radiation. Results: The locoregional control was similar in both the arms at 1st follow up as well as at median follow up. However a trend towards better response was seen with cisplatin arm. The acute toxicities in Hydroxyurea arm were more but they were managed conservatively. Conclusions: Hydroxyurea can be used in the patients of head and neck cancers as a radio sensitizer where the use of cisplatin is precluded like old age, comorbidities or patient is reluctant for weekly injectable chemotherapy or in developing countries like India, where infrastructure is lacking.
Authors and Affiliations
Poorva V
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