INDUCTION CHEMOTHERAPY FOLLOWED BY CONCURRENT CHEMORADIOTHERAPY VERSUS CONCURRENT CHEMORADIOTHERAPY ALONE IN LOCALLY ADVANCED NASOPHARYNGEAL CANCER

Sajib Kumar Talukdhar*, Sarwar Alam, Md. Abdul Bari, Md. Zillur Rahman Bhuiyan, Sadia Sharmin and Md. Abdullah Al Maruf

ABSTRACT

Background: Concurrent chemoradiotherapy is the standard of care for patients with locally advanced nasopharyngeal carcinoma. Addition of induction chemotherapy remains unclear. Objective: The aim of this study was to compare the treatment response and toxicity of induction chemotherapy followed by concurrent chemoradiotherapy and concurrent chemoradiotherapy alone in locally advanced nasopharyngeal cancers. Materials and Methods: This quasi-experimental study was carried out among 80 patients of locally advanced squamous cell carcinoma of nasopharynx from June, 2018 to June, 2019. Who had fulfilled the inclusion and exclusion criteria were included and equally distributed into two treatment arms. Arm A received induction chemotherapy followed by concurrent chemoradiotherapy and Arm B received concurrent chemoradiotherapy alone. Results: Final responses were evaluated 3 months after the end of treatment. In Arm A, 27 (67.5%) patients showed complete response (CR) and in Arm B, CR was observed in 15 (37.5%) patients. Partial responses (PR) were 11 (27.5%) and 21 (52.5%) in two arms respectively. There were 02 (5.0%) progressive disease (PD) in Arm A and 04 (10.0%) PD in Arm B. Treatment responses were statistically significant between two groups (p-value=0.032). Toxic effects during chemoradiotherapy were almost similar in the two arms. Conclusion: Induction chemotherapy followed by concurrent chemoradiotherapy is more effective than concurrent chemoradiotherapy alone in locally advanced squamous cell carcinoma of nasopharynx with acceptable toxicities.

Keywords: Nasopharyngeal cancer, Squamous cell carcinoma, Induction chemotherapy, Concurrent chemoradiotherapy.