Assessing feasibility, compliance and toxicity of concomitant chemo-radiotherapy in head and neck cancers in the Northern Territory: initial experience and challenges

• DOI: 10.1002/jmrs.183
• Publication Date: 2016-07-02T04:56:44Z
• Authors: Ajay Gupta; Siddhartha Baxi; Christopher Hoyne
• Keywords: Concomitant

Introduction Comprehensive oncology services have recently been introduced in the Northern Territory (NT) enabling delivery of concurrent chemo-radiotherapy (CCRT) locally advanced head and neck squamous cell carcinoma (LAHNSC). The purpose this study is to assess feasibility, compliance toxicity CCRT remote Australia. Methods Chart review was conducted for all patients >18 years, with biopsy-proven LAHNSC, receiving curative intent between January 2010 September 2012. Results population comprised 26 patients, 20 Caucasian 6 Indigenous, having a median age 58 most common sites involvement being oropharynx (n = 16) oral cavity 6). Major risk factors were smoking alcoholism. Cardiovascular disease, viral hepatitis, latent tuberculosis strongyloidosis major comorbidities. Fifty-eight per cent 15) required assisted feeding. All received intensity modulated radiotherapy. Systemic therapy cisplatin or carboplatin/cetuximab. Most acute (grade 3/4) toxicities mucositis, dysphagia dermatological 54%, 31% 23% respectively. Complications infection gastrostomy insertion related. Hospitalisation occurred 23%, treatment break >2 days 38%, no difference indigenous nonindigenous patients. Platinum use associated greater nausea (P 0.003), renal dysfunction 0.03) ototoxicity 0.04) cetuximab reactions 0.05). At follow-up 16 months, overall survival 58% progression-free 50%. Conclusions We demonstrated good rates, tolerance feasibility outcomes. seeming preponderance LAHNSC NT cause concern.