EUROPEAN JOURNAL OF
PHARMACEUTICAL AND MEDICAL RESEARCH

( An ISO 9001:2015 Certified International Journal )

An International Peer Reviewed Journal for Pharmaceutical, Medical & Biological Sciences

An Official Publication of Society for Advance Healthcare Research (Reg. No. : 01/01/01/31674/16)

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 ISSN 2394-3211

Impact Factor: 7.065

 ICV - 79.57

Abstract

HYPOFRACTIONATED INTENSITY MODULATED RADIOTHERAPY WITH CONCURRENT CHEMOTHERAPY FOR LOCALLY ADVANCED SQUAMOUS CELL CARCINOMA OF HEAD AND NECK -A PILOT STUDY

Bhaskar Vishwanathan*, Dr. Christopher and Swathi Reddy

ABSTRACT

Introduction: Head and neck carcinoma is common cancer in India often presenting in advanced stage and unresectable. These patients are usually relegated to palliative treatment. Study undertaken with the intention of treating these patients with radical intent using, hypo-fractionated IMRT and concurrent chemotherapy. Primary objective is to assess loco-regional response and post-treatment resectable status. Secondary objective is to assess the toxicity. Methods and Materials: 20 patients of stage III and IV Head and Neck squamous cell carcinoma (HNSCC) were treated with Hypofractionated IMRT and chemotherapy. RT of 45Gy in 15 Fractions delivered to the primary tumor and involved lymph nodes, 37.5Gy in 15 Fractions to low intermediate risk areas with simultaneous Integrated Boost (SIB), using 6MV photons with an overall treatment time (OTT) of 3 weeks. Infusion Cisplatin (70mg/m2) on day 1 and last day of treatment was given. Resectable tumors underwent surgery and remaining patients boosted to a radical dose of 16Gy in 8 fractions. Results: 90% (18/20) completed treatment & 45% (9/20) made resectable following hypofractionated neo-adjuvant chemoradition. 35%(7/20) underwent surgery. At three months, 50% (10/20) were loco regionally controlled.30% (6/20) developed grade II, 60% (12/20) grade III and 5% (1/20) grade IV mucositis. 20% (4/20) had grade I, 60% (12/20) grade II and (1/20) 5% Grade III skin reactions. Conclusion and Discussion: Neo-adjuvant Hypofractionated IMRT with concurrent chemo radiation is clinically feasible with good response rates in the treatment of locally advanced HNSCC with acceptable toxicities and conversion rates to surgery.

Keywords: Hypofractionation, Locally advanced squamous cell cancer of head and neck, chemotherapy, cisplatin.


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Google Scholar Indian Science Publications InfoBase Index (In Process) SOCOLAR, China Research Bible, Fuchu, Tokyo. JAPAN International Society for Research activity (ISRA) Scientific Indexing Services (SIS) Polish Scholarly Bibliography Global Impact Factor (GIF) (Under Process) Universal Impact Factor International Scientific Indexing (ISI), UAE Index Copernicus CAS (A Division of American Chemical Society) USA (Under Process) Directory of Open Access Journal (DOAJ, Sweden, in process) UDLedge Science Citation Index CiteFactor Directory Of Research Journal Indexing (DRJI) Indian citation Index (ICI) Journal Index (JI, Under Process) Directory of abstract indexing for Journals (DAIJ) Open Access Journals (Under Process) Impact Factor Services For International Journals (IFSIJ) Cosmos Impact Factor Jour Informatics (Under Process) Eurasian Scientific Journal Index (ESJI) International Innovative Journal Impact Factor (IIJIF) Science Library Index, Dubai, United Arab Emirates Pubmed Database [NLM ID: 101669306] (Under Process) IP Indexing (IP Value 2.40) Web of Science Group (Under Process) Directory of Research Journals Indexing Scholar Article Journal Index (SAJI) International Scientific Indexing ( ISI ) Scope Database Academia