Published: 2017-01-23

A comparative study of radical radiotherapy with weekly paclitaxel versus radical radiotherapy with weekly cisplatin in the management of locally advanced squamous cell carcinomas of head and neck

Ram Madhavan, Bhaskar P.K, Antonoitte Mary Nithiya, Janarthina Kani, Madhu mathi, Balasubramaniam P, Shanmuga Kumar


Background: Concurrent chemo radiation is standard of care in locally advanced squamous cell carcinomas of head and neck. Single agent Cisplatin either weekly or three weekly is commonly used concurrently with radiation. The present study aims to evaluate the response rate and toxicity of radical radiotherapy with weekly paclitaxel and cisplatin in head and neck cancers.

Methods: This is a prospective double arm study in which sixty patients with histologically proved squamous cell carcinomas registered in our department were accrued into the study with thirty patients in each arm. All patients were treated using Theratron phoenix 780 cobalt unit with a dose of 66 Gy in 33 fractions. The patients were randomized to receive 40 mg/m2 of weekly cisplatin or 40 mg/m2 of weekly Paclitaxel concurrently with radiation. The response to the therapy was assessed six weeks after completion of treatment. The statistical analysis was done using SPSS software.

Results: In cisplatin group 18 patients achieved complete response and 12 patients achieved partial response whereas in Paclitaxel group 21 patients achieved complete response and 9 patients achieved partial response. However in paclitaxel arm the incidence of radiation dermatitis, mucositis, dysphagia and laryngitis are slightly higher compared to cisplatin group.

Conclusions: The weekly paclitaxel concurrent with radiation is a feasible alternative to weekly cisplatin in locally advanced squamous cell carcinomas of head and neck.


Cisplatin, Paclitaxel, Radiation therapy

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Blanchard P, Baujat B, Hotostenco V, Bourredjem A, Baey C, Bourhis J et al. Meta analysis of chemotherapy in head and neck cancer (MACH NC) A comprehensive analysis by tumour site, Radiotherapy and Oncology.2001;100:33-40.

Homma A, Inamura N, Oridate N, Suzula S, Hatakeyama H, Mizumachi T et al. Concomitant weekly Cisplatin and radiotherapy for head and neck cancer. Jpn J Clin Oncol.2011; 41: 980-86.

F Kose, AA, Besen AT, Sumbul A, Sezer C, Karadeniz C, Disel U et al. Weekly Cisplatin versus standard three weekly Cisplatin in concurrent chemo radiotherapy of head and neck cancer; Basket University Experience. Asian Pacific Journal of Cancer Prevention. 2011; 12:1185-88.

Tejpal Gupta, Jai P Agarwal, Sarbani Ghosh Laskar, Purvish M Parikh, Anil K D’Cruz and Ketayun A Dinshaw. Radical Radiotherapy with concurrent weekly Cisplatin in loco regionally advanced squamous cell carcinomas of head and neck: a single institution experience. Head and neck oncology. Published online 2009 Jun 15. doi: 10.1186/1758-3284-1-17

Rehan Asif, Kamalesh Chandra, Vanita Chopra and M L B Bhatt. Concurrent Cisplatin and radiotherapy in advanced Head and Neck Cancer. Indian Journal of Otolaryngology and Head & Neck Surgery.2003; 55:94-96.

Lone M Maqbool , Tariq R Malik , Fir Afroza, Khan N A , Muhibul Haq and Patigaroo A R. Treatment Outcome with Weekly Cisplatin Concurrent with Radiation Therapy in Locally Advanced Head and Neck Squamous Cell Carcinoma.JIMSA.2012;25:159-161.

Essa HH, Azzam M. Concurrent chemo radiation in locally advanced head and neck cancers, a comparative study of weekly paclitaxel versus cisplatin based regimen, J Egypt Nati Canc Inst. 2010;22:165 -73.

Sohit Paul, Kanotra, Sonika Kanotra Ashuthosh Gupta and J Paul. Chemo radiation in Advanced Head and Neck cancers; A comparative study of two radiation radiosensitisers, Paclitaxel and Cisplatin. Indian J of Otolaryngology and head and neck surgery.2011; 63:229-236.

Jain RK, Kirar P, Gupta G, Dubeys, Gupta SK, Goyal J. A comparative study of low dose weekly Paclitaxel versus Cisplatin with concurrent radiation in treatment of Locally Advanced Head and neck Carcinoma. Ind. Journal of cancer. 2009;46:50-53.

Hoffman W, Belkac, Schmidberger N, Budach W, Bochtler H, Hess C F et al. Radiotherapy and concomitant weekly one hour infusion of Paclitaxel in the treatment of head and neck cancer, Results from a phase I trial.Int.J. Radiat. Oncol Biol Phys. 1997;38: 691-696.