title: Weekly chemotherapy as Induction chemotherapy in locally advanced head and neck cancer for patients ineligible for 3 weekly maximum tolerable dose chemotherapy.
abstract: OBJECTIVE
  To study the safety and efficacy of weekly chemotherapy as part of induction chemotherapy, in locally advanced head and neck cancer for patients, who are unfit for upfront radical treatment.
  
  
  METHODS
  It is a retrospective analysis of on-use weekly chemotherapy as Induction chemotherapy in locally advanced head and neck cancer, who are technically unresectable are unfit for upfront radical treatment. Induction chemotherapy given was a 2 drug combination of paclitaxel (80 mg/m 2 ) and carboplatin AUC 2. The decision to give weekly induction chemotherapy was given on the basis of presence of 2 more following features: Poor performance status (ECOG PS 2-3), presence of uncontrolled co morbidities, BMI below 18.5 kg/m 2 and age more than 60 years. The Statistical Package for the Social Sciences software (SPSS version 16.0) was used for analysis. The response rates, toxicity (accordance with CTCAE vs. 4.02), completion rate (Cp) of radical intent treatment post neoadjuvant chemotherapy (NACT), progression-free survival (PFS) and overall survival (OS) are reported.
  
  
  RESULTS
  Fifteen patients were considered for such therapy. Fourteen out of fifteen patients completed NACT. The median numbers of planned weekly cycles were 6 (3-8). Response (CR + PR) was seen in 10 patients. Overall grade 3-4 toxicity was seen in 6 patients. No toxicity related mortality was noted. The calculated completion rate (Cp) of radical intent treatment post NACT was 46.7%. The median PFS and OS were 10.36 months (95% CI 6.73-14.00 months) and 16.53 months (95% CI 4.22-28.84).
  
  
  CONCLUSIONS
  Use of induction chemotherapy with weekly regimen is safe and effective selected cohort of patients with locally advanced disease who are unfit for upfront radical treatment.
authors.forename: Vijay Maruti
authors.initials: VM
authors.lastname: Patil
authors.forename: Vanita
authors.initials: V
authors.lastname: Noronha
authors.forename: Amit
authors.initials: A
authors.lastname: Joshi
authors.forename: Vamshi Krishna
authors.initials: VK
authors.lastname: Muddu
authors.forename: Sachin
authors.initials: S
authors.lastname: Dhumal
authors.forename: Supreeta
authors.initials: S
authors.lastname: Arya
authors.forename: Shashikant
authors.initials: S
authors.lastname: Juvekar
authors.forename: P
authors.initials: P
authors.lastname: Pai
authors.forename: Pankaj
authors.initials: P
authors.lastname: Chatturvedi
authors.forename: Arvind Chaukar
authors.initials: AC
authors.lastname: Devendra
authors.forename: Sarbani
authors.initials: S
authors.lastname: Ghosh
authors.forename: Anil
authors.initials: A
authors.lastname: D'cruz
authors.affiliation: Department of Medical Oncology, Tata Memorial Hospital, Mumbai, Maharashtra, India.
authors.forename: Prabhash
authors.initials: P
authors.lastname: Kumar
mesh_terms: D000328:Adult; D000368:Aged; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D016190:Carboplatin / Q000008:administration & dosage; D002294:Carcinoma, Squamous Cell / Q000188:drug therapy* / Q000401:mortality / Q000473:pathology; D005260:Female; D005500:Follow-Up Studies; D006258:Head and Neck Neoplasms / Q000188:drug therapy* / Q000401:mortality / Q000473:pathology; D006801:Humans; D060828:Induction Chemotherapy; D008297:Male; D020714:Maximum Tolerated Dose; D008875:Middle Aged; D020360:Neoadjuvant Therapy; D009367:Neoplasm Staging; D017239:Paclitaxel / Q000008:administration & dosage; D011379:Prognosis; D012074:Remission Induction; D012189:Retrospective Studies; D015996:Survival Rate
chemical_list: D016190:Carboplatin; D017239:Paclitaxel