TO COMPARE THE TOXICITY PROFILE OF ACCELERATED RADIOTHERAPY (SIX FRACTIONS PER WEEK) WITH CONCOMITANT CHEMO-RADIOTHERAPY IN LOCALLY ADVANCED HEAD AND NECK CANCER

Background: Head and neck malignancies are common among males in India. The age adjusted incidence rate of head and neck cancer in India in males is 16.4/100,000 and in females it is 8.8/100,000.In All India Institute of Medical Science head and neck cancer represents 25% of all malignancies registered Methods: This prospective randomized study was conducted in the Department of Radiation Therapy & Oncology, Regional Cancer Centre, IGMC, Shimla and patients were enrolled for a period of one year, from July 2012 to July 2013.It included all the eligible, previously untreated patients of squamous cell carcinoma of Head and Neck with histologically confirmed diagnosis and no evidence of distant metastasis. The sites included were oro-pharynx, hypo-pharynx and larynx with stages III, IV A and IV B. Results: Grade 3 and grade 4 skin toxicities were higher in CRT arm but without statistically significant difference from that in ART arm. G3 & G4 mucositis was higher in the Concomitant CRT arm however the difference was not statistically significant. G2 and G3 Laryngeal Toxicities were higher in Concomitant CRT arm as compared to Accelerated arm but the difference was not statistically significant. G2 & G3 haematological toxicities were significantly (combined p value = 0.002) higher in the concomitant CRT arm (32.4%) as compared to Accelerated RT arm (2.9%). Only one patient in accelerated arm had any hematological toxicity. Conclusion: Higher peak incidence of toxicities was seen in concomitant CRT arm as compared to accelerated arm. Keywords: Toxocity, six fraction, chemoradiation, Local control