الفهرس يوجد فقط 14 صفحة متاحة للعرض العام
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المستخلص
In this work we aimed to compare the outcome of the sequential therapy Induction Chemotherapy Followed by Concomitant chemoradiotherapy) with the concomitant chemoradiotherapy in treatment of LAHNC. We performed this comparison through: (1) a retrospective analysis of the outcome of 69 patients with stage III and IV non metastatic head and neck cancers, multiple sites and 2) a Literature based meta-analysis of forty-six prospective trials with a total number of about seven thousands patients. All patients were received either ST or CRT Concomitant chemoradiotherapy was widely adopted as standard of care for patients with LAHNC, however the sequential approach is still investigational. In this work we aimed to evaluate the possible therapeutic gain of addition of neoadjuvant chemotherapy before concomitant chemoradiotherapy hoping to improve the poor outcome of this group of patients In the retrospective analysis the sequential approach achieved better overall response rate of 64% compared to 60% for CRT and it was statistically significant (p 0.05). The overall treatment related toxicities were higher in the sequential arm (87.1%) compared to (56.67%) for the CRT arm and the difference was highly significant (p 0.001**). The local control, distant control, OAS, PFS, and DFS were better in the sequential arm than the CRT however; the difference did not reach the statistical significance (p 0.05).