COMPARISON OF TREATMENT RELATED TOXICITIES OF CONCURRENT CHEMO- RADIOTHERAPY VS INDUCTION CHEMOTHERAPY FOLLOWED BY RADIOTHERAPY IN LOCALLY ADVANCED OROPHARYNGEAL CANCER

Zobair Islam*, Nayan Bhowmik, Julekha Khatun, Ashim Kumar Ghosh and AKM Ahsan Habib

ABSTRACT

Background: Locally advanced oropharyngeal cancer (OPC) treatment often requires a combination of chemotherapy and radiotherapy. However, treatment response and associated toxicities remain a challenge in clinical management. Objective: This study aims to assess the treatment related toxicities in patients with locally advanced oropharyngeal cancer receiving two different treatment regimens: concurrent chemoradiotherapy (CRT) versus induction chemotherapy followed by radiotherapy. Methods: A total of 62 patients diagnosed with locally advanced OPC were assigned to two groups: Arm-A (concurrent CRT) and Arm-B (induction chemotherapy followed by radiotherapy). The study was conducted at Rajshahi Medical College and Hospital from January 2021 to June 2022. Toxicities were assessed based on standard grading criteria, and statistical analysis was conducted using chi-square tests, with p-values calculated for comparison between the two arms. Standard deviation (SD) and mean values were also computed for the toxicity incidence. Results: The results indicated that the majority of toxicities were Grade 1 and Grade 2, with very few instances of Grade 3 toxicity. In Arm-A, 58.1% of patients developed dysphagia, whereas in Arm-B, 67.7% were affected (p = 0.620). For oral mucositis, 48.4% in Arm-A and 51.6% in Arm-B developed Grade 1 toxicity (p = 0.940). Skin toxicity (p=0.568), Xerostomia occurred in 51.6% of Arm-A and 54.8% of Arm-B patients (p = 0.799). Hematological toxicities showed no significant difference in neutropenia (p = 0.688), anemia (p = 0.639), and thrombocytopenia (p = 0.778). Standard deviation values for treatment-related toxicities ranged between 2.0 to 6.3 across both arms. The p-value of all comparisons was greater than 0.05, indicating no statistically significant difference between the groups. Conclusion: Further research focusing on personalized treatment strategies is needed to optimize patient care and minimize toxicity.

Keywords: Oropharyngeal Cancer, Radiotherapy, Chemotherapy, Toxicity.