Carboplatin Based Chemoradiation Therapy In Locally Advanced Head And Neck Cancer Patients Who Are Unfit For Cisplatin Therapy.

Background: Cisplatin based chemoradiation (CTRT) is the standard of care in locally advanced head and neck cancers. Limited treatment options are available in patients unfit for cisplatin. Aims: This audit was carried out to study the toxicities, tolerance and outcomes of carboplatin based CTRT in patients who were not eligible for cisplatin. Materials and Methods: A total of 63 locally advanced head and neck cancer patients treated between January 2011- October 2015 were administered carboplatin based CTRT. The dose of carboplatin was AUC-2 weekly for maximum 7 cycles. Toxicity was coded as per CTCAE version 4.03. SPSS version 16 was used for analysis. Statistical Analysis: Descriptive statistics was performed. Progression free survival (PFS) and overall survival (OS) were estimated by Kaplan Meier survival analysis. Cox proportional hazard model was used for identifying factors affecting PFS and OS. Results: The reasons for patients being unfit for cisplatin were low serum creatinine clearance in 41 (65.07%), sensorineural hearing loss in 18 (28.57%), uncontrolled medical comorbidity in 03 (4.76%) and old age in 1 patient (1.6%) respectively. 53 patients (84.1%) completed planned radiotherapy. Median number of chemotherapy cycles administered was six. Grade 3-4 toxicities were seen in 32 patients (50.8%). The median OS and PFS were 28 months (95%CI 20.9-34.6 months) and 17 months (95%CI 08.2-25.7 months) respectively. Age was the only factor significantly affecting OS and PFS. Conclusion: Carboplatin based CTRT is well tolerated in patients unfit for cisplatin and seems to have superior outcomes than those reported in radical radiotherapy studies. [ABSTRACT FROM AUTHOR]