الفهرس 
EpidemiologyOnly 14 pages are availabe for public view
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Abstract
Overall, head and neck cancer accounts for more than 550,000 cases
annually worldwide (Jamal et al., 2013). World-wide, the head and neck cancers
form the sixth most common cancer and is the most common cancer in
developing countries (Joshi et al .,2014).
Surgery and radiotherapy are the major treatment modalities, combined
with different chemotherapy schemes. The increased specialisation and
complexity of knowledge has led to the introduction of Multidisciplinary Teams
(MDT) for the management of these patients. MDT pursues to ensure that all
patients will benefit from the knowledge of a variety of specialists, who can share
their expertise, professional perspective, and knowledge (Brown et al.,2012).
Concurrent administration of chemotherapy and radiotherapy is a
promising approach for treating patients with locally advanced head and neck
cancer. Moreover chemotherapy given as part of concurrent chemoradiation may
act systemically and potentially eradicate distant micrometastases( Herman et al.,
2014). Concomitant chemoradiation treatment with platinum containing
regimens particularly at the treatment of unresectable head and neck cancers has
been used as an effective treatment as combined therapy has proven to be
superior to radiotherapy alone in terms of overall survival, disease free survival
and local control (Forastiere et al., 2013) . In currant study conducted in the department of clinical oncology and nuclear
medicine in Ain-Shams University, CRT in locally advanced non-nasopharyngeal
unresectable patients was evaluated. Results have shown slight superiority of
cisplatin over carboplatin was shown with overall response rate was 53 % versus
50 % in cisplatin and carboplatin respectively. Mean overall survival in our study
group was 20 months , with 22.7 months and 17 months in cisplatin and
carboplatin respectively. Mean PFS was 18.2 months , 19.3 months with cisplatin
and 15.6 months with carboplatin. As regard toxicity, mucositis was the most
comman acute toxicity in 60% of our patients and was comparable in both
cisplatin and carboplatin. Other acute toxicities recorded was xerostomia,
dysphagia, vomiting and nephrotoxicity. As regard late toxicity, grade II dysphagia
was the most comman toxicity with 44.4 % of patients. Xerostomia, fibrosis and
skin toxicity were other late toxicities seen in the study.
Staging, initial ECOG status , and response rate were found to be influencial
prognostic factors while age, sex and induction chemotherapy were independent
prognostic factors in our study group.