الفهرس 
Introduction and aim of the workOnly 14 pages are availabe for public view
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Abstract
This study was carried out at Clinical Oncology and Nuclear
Medicine Departement at Sohag faculty of medicine during the period
from July 2008 to December 2010. It aimed to compare the outcome
(response, survival and toxicity profile) of low dose gemcitabine based
chemoirradiation with cisplatin based chemoirradiation. Sixty patients
with locally advanced HNSCC were enrolled.
The patients were treated in two equal groups. Seven patients were
excluded from the study, Four from group A (tested regimen) and three
from group B (standard regimen). one of them – from group A – died
from cerebral infarction developed at week 4 of treatment and the others
discontinued treatment between week 4 and 6 of treatment and refused
follow up and to receive an alternative line of treatment.
All patients had histopathologically confirmed diagnosis of SCC,
all of them were not treated befor against HNSCC. Our patients had
adequate medical condition with adequate hepatic and renal functions and
a written informed consent was given by each patient.
Patients in group A received radical dose of RT (70 GY)
concurrent with weekly 50 mg/m2 gemcitabine for 7 weeks and in group
B, they received the same dose of RT concurrent with cisplatin 100
mg/m2 every 3 weeks (day 1, 22 and 43).
At the end of treatment 53 patients were eligible for evaluation, 26
from group A and 27 from group B.
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Summary, conclusion and recommendations
١٥٩
The most frequent primary tumor site was laryngeal primary in
both groups.
There was no statistically significant difference between two
groups as regard patient’s characteristics.
There was statistically signifcant difference between the lymph
node staging distribution and pathological grades in the two groups.
Gemcitabine based chemoirradiation offered the same overall
response rate as that of cisplatin based one which was 100% objective
response rate (≈ 77% CR and ≈ 23% PR in both groups).
No statistically signifcant effect of any of the patient’s or tumor’s
prognostic factors on response. However, there was a trend for better
response in patients of group A with T2 or pathological grade II and a
trend for better response in patients of group B with laryngeal cancer.
At a median follow-up time of 24 months in both groups, the 2-
year overall survival (OS) was 53.84% and 51.85% in group A and B
respectively.
The 2-year progression-free survival (PFS) was 46.15% and
48.14% in group A and B respectively.
The 2-year disease-free survival (DFS) was 38.46% and 44.44% in
group A and B respectively.
No statistically significant difference between group A and B as
regards to overall survival, progression-free survival and disease-free
survival.
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Summary, conclusion and recommendations
١٦٠
There was no statistically significant effect of primary tumor site,
disease stage, nodal status or response on survival in group A patients.
There was a statistically significant effect of primary tumor site on
survival in group B patients. This was evident in laryngeal cancer patients
who showed better survival than those with other primaries. This effect
was abolished when adjusted for other factors affecting survival.
Response had a statistically significant effect on survival in group
B patients. This was evident in patients who attained partial response
(PR) and showed a lower survival than those with (CR). However, this
effect was abolished when adjusted for other factors affecting survival.
Disease stage, nodal status had no statistically significant effect on
survival in group B patients.
The major acute toxicity encountered was acute mucositis and
there was a statistically signifcant difference between the two groups as
regard this, where high grade mucositis was frequently experienced in
group A (77%) versus 7.5% in group B.
The major chronic toxicities encountered were chronic mucosal
toxicity and xerostomia. There was a statistically signifcant difference
between the two groups as regard this, where high grade chronic mucosal
toxicity and xerostomia were experienced in group A.