Induction chemotherapy by cisplatin, 5-FU and leucovorin versus cisplatin and 5-FU followed by chemoradiotherapy in locally advanced head and neck cancer

A. Z. M. Sumsuzoha; Muhammad Adnan Arifeen; M. Ershadul Haque; Ahammad Al Mamun Sweet; M. Ruhul Amin Bhuiyan; Khandakar Rezwan Bayzid; M. Nazmul Alam

doi:10.18203/2320-6012.ijrms20252381

Authors

A. Z. M. Sumsuzoha Department of Oncology, TMSS Medical College & Rafatullah Community Hospital, Bogura, Bangladesh
Muhammad Adnan Arifeen Department of Oncology, TMSS Medical College & Rafatullah Community Hospital, Bogura, Bangladesh
M. Ershadul Haque Department of Radiotherapy, Rangpur Medical College Hospital, Rangpur, Bangladesh
Ahammad Al Mamun Sweet Department of Clinical & Radiation Oncology, Lab Aid Cancer Hospital and Super Speciality Centre, Dhaka, Bangladesh
M. Ruhul Amin Bhuiyan Department of Oncology, North East Medical College Hospital, Sylhet, Bangladesh
Khandakar Rezwan Bayzid Department of Radiation Oncology, Lab Aid Cancer Hospital and Super Speciality Centre, Dhaka, Bangladesh
M. Nazmul Alam Department of Oncology, Khwaja Yunus Ali Medical College Hospital, Sirajganj, Bangladesh

DOI:

https://doi.org/10.18203/2320-6012.ijrms20252381

Keywords:

Head, Neck, Cancer, Chemotherapy, Chemoradiotherapy

Abstract

Background: Head and neck squamous cell carcinoma (HNSCC) is a prevalent malignancy in Bangladesh, with many patients presenting in advanced stages. The study aimed to compare the therapeutic efficacy and safety profile of induction chemotherapy using Cisplatin, 5-fluorouracil (5-FU), and Leucovorin versus Cisplatin and 5-FU followed by chemoradiotherapy in patients with locally advanced HNSCC.

Methods: This quasi-experimental study was conducted at KYAMCH over 18 months, involving 80 patients divided into two treatment arms. Arm A received ICT with Cisplatin and 5-FU followed by CRT; Arm B received Cisplatin, 5-FU and Leucovorin followed by CRT.

Results: 80 patients were evenly randomized into Arm A and Arm B, with comparable baseline characteristics (mean age ~52 years, predominantly male, and similar ECOG performance status; all p>0.05). Tumor and disease profiles showed no significant differences between groups (all p>0.05), with Stage IVA and moderately differentiated tumors being most common. After induction chemotherapy, partial response was the predominant outcome in both arms, while complete response rates were higher in Arm B (27.5% vs. 17.5%), but this difference was not statistically significant (p=0.550). Longitudinal assessment at 6, 12, and 24 weeks showed increasing complete response rates in both arms, peaking at 24 weeks (60.0% Arm A, 65.0% Arm B), with no significant differences at any timepoint (p>0.85).

Conclusion: Both treatment arms showed comparable efficacy and safety, with slightly higher complete response rates and toxicity in the arm receiving chemoradiotherapy. No statistically significant differences were observed.

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