Concurrent chemo-radiotherapy of weekly paclitaxel versus weekly carboplatin in locally advanced head and neck carcinomas unfit for cisplatin

Background: Chemoradiotherapy have an important role in the treatment of locally advanced head and neck cancers, in old age patients with, renal and cardiac dysfunction ineligible for cisplatin, We compared weekly Taxol versus weekly carboplatin .AIM: Our study aiming to comparing the efficacy and toxicities of chemo radiotherapy of weekly Taxol versus weekly carboplatin in locally advanced head and neck carcinoma. PATIENT AND METHODS: The study divided in two arms, paclitaxel arm; 25patients treated by weekly paclitaxel 40mg/m2 with radiotherapy and carboplatin arm; 25 patients treated by weekly 150mg carboplatin with radiotherapy. The three-dimensional radiotherapy planned (3DCRT) was 65 to 70 GY and 1.8 -2 GY /fraction, 5 fractions/week in 6-7 weeks. RESULTS: There was an insignificant 5-year disease free survival was 79.5% in carboplatin arm versus 84.6% in paclitaxel arm and 5-year OS was an insignificant 76% in carboplatin arm versus 72% in paclitaxel arm (p-value=0.646) . A 44% of both arms had overall complete remission. A 16% of patients received carboplatin had grade III/IV mucositis. Patients in paclitaxel arm had more grade II neuropathy (60%). A comparable rate of neutropenia had occurred in both arms. CONCLUSION: Both arms of concurrent chemo radiotherapy had acceptable toxicities with good quality of life response to treatment where 44% of both arms had complete response (p-value=0.623). There was an insignificant 5-year disease free survival was 79.5% in carboplatin arm versus 84.6% in paclitaxel arm and 5-year OS was an insignificant 76% in carboplatin arm versus 72% in paclitaxel arm (p-value=0.646).