Tactics of chemoradiotherapy in patients with locally advanced squamous cell carcinoma of the pharynx with index of metastatic regional lymph nodes stage N3

Abstract

During 1996–2015 years, 53 patients with stage locally-advanced squamous cell carcinoma of the pharynx with stage N3 were treated in N. N. Blokhin National Research Center of Oncology. Depending on the treatment method, patients were divided into 2 groups: concurrent (n = 26) and induction (n = 27) chemoradiotherapy. Concurrent chemoradiotherapy (option 1) was given using: cisplatin 100 mg/m² – every 3 weeks, or carboplatin 1.5 AUC weekly, or cisplatin 100 mg/m² with 5-fluorouracil 1000 mg/m² every 24 hours, in continuous infusion for 96 hours (PF). Induction chemotherapy (option 2) was performed in 2 modes: TPF (docetaxel, cisplatin, 5-fluorouracil) or PF (cisplatin, 5-fluorouracil). Radiation therapy was performed on a linear accelerator for 2 Gy daily up to SD 68–70 Gy for the primary tumor and 66 Gy for the affected lymph nodes. According to the results of our retrospective study, the 3 year overall and relapse-free survival rate depending on the chemoradiotherapy option was 37 and 32 % (option 1), 62 and 56 % (option 2). A promising option for chemoradiotherapy of locally advanced squamous cell carcinoma of the pharynx is induction chemoradiotherapy.