Concurrent paclitaxel versus cisplatin with external beam radiotherapy in locally advanced head and neck cancer patients: a comparative study

Background: The management of locally advanced head and neck cancer (HNC) requires a multidisciplinary approach. With a paradigm shift towards organ preservation, concurrent chemo radiation (CCRT) has taken a more centralized place in the management of HNC. This study aimed to compare the efficacy of CCRT with weekly paclitaxel versus weekly cisplatin in locally advanced squamous cell carcinoma of the head and neck (SCCHN). Methods: This quasi-experimental study was conducted at the Department of Oncology, Khwaja Yunus Ali Medical College and Hospital (KYAMCH), Enayetpur, Sirajganj, from June 2019 to December 2020. A total of 64 patients were selected by purposive sampling technique. Study subjects were divided into 2 arms- arm A and arm B, each arm contained 32 patients. Results: In arm A 53.12% showed complete response whereas in arm B CR showed 62.5%. Partial response was 31.25% and 28.12% in arm A and B respectively. Stable disease was 9.37% and 6.25% in arm A and B respectively. 2 patients in arm A and 1 patient in arm B showed progressive disease at the final follow-up. The difference was statistically not significant (p value >0.05). Conclusions: This study concludes that overall treatment response was more in the paclitaxel arm compared to the cisplatin arm. So, CCRT by low dose weekly paclitaxel given in conventional fractionation can be substituted to concurrent cisplatin in locally advanced SCCHN in terms of efficacy and some manageable local toxicities.