ETIOLOGICAL, CLINICAL AND PATHOLOGICAL PROGNOSTIC MARKERS IN HEAD AND NECK CANCERS TREATED WITH CONCURRENT CHEMO-RADIATION

  • Ankur Yadav Department of Radiotherapy, Delhi State Cancer Institute, New Delhi
  • Piyush Kumar Department of Radiotherapy, *Department of Pathology, Shri Ram Murti Smarak Institute of Medical Sciences, Bareilly, Uttar Pradesh
  • Arvind Kumar Chauhan Department of Radiotherapy, *Department of Pathology, Shri Ram Murti Smarak Institute of Medical Sciences, Bareilly, Uttar Pradesh
  • Milan Jaiswal Department of Radiotherapy, *Department of Pathology, Shri Ram Murti Smarak Institute of Medical Sciences, Bareilly, Uttar Pradesh
  • D. P. Singh Department of Radiotherapy, *Department of Pathology, Shri Ram Murti Smarak Institute of Medical Sciences, Bareilly, Uttar Pradesh

Abstract

Introduction: Advanced squamous cell carcinoma of head and neck are usually treated with


surgery and/or radiotherapy. Integration of chemotherapy also plays an important role for


improving organ preservation. Various prognostic factors help in selecting the appropriate


treatment regimen for the individual patient. The present study was conducted to identify the


prognostic factors in head and neck cancers.


Material and Methods: Previously untreated 33 patients of squamous cell carcinoma were


selected. They were treated with concurrent chemotherapy and radiotherapy. The response


assessment was analyzed in terms of various patient, tumor and treatment related factors.


Statistical analysis was done using chi square test.


Results: Etiological factors tobacco & alcohol, non-vegetarean diet were associated with a


poor outcome but were not statistically significant. Clinical factors- like higher N-stage


(p=0.04) and AJCC stage (p=0.03) were found to be significant predictors of poor prognosis


while T-stage was not found significant, probably due to short follow-up. Patients receiving


less than 5 cycles of concurrent chemotherapy had a significantly worse prognosis (p=0.04).


Among the pathological factors that were studied, high mitotic index (Grade III or more) were


associated with a significantly poorer prognosis (p=0.04).


Conclusion: Many clinico pathological factors have been correlated with locoregional control


in head and neck cancers. These can be used to individualize the treatment by different surgical


techniques, various radiotherapy dose & fractionation schedules and chemotherapy protocols.

Keywords: head and neck cancer, chemoradiation, prognostic markers

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Author Biography

Ankur Yadav, Department of Radiotherapy, Delhi State Cancer Institute, New Delhi

1#, Piyush Kumar2, Arvind Kumar Chauhan3, Milan Jaiswal2*, D. P. Singh2

Department of Radiotherapy, *Department of Pathology, Shri Ram Murti Smarak Institute of Medical Sciences, Bareilly, Uttar Pradesh

#Department of Radiotherapy, Delhi State Cancer Institute, New Delhi

Corresponding Author : Piyush Kumar; Email: piykumagr@gmail.com

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[1]
A. Yadav, P. Kumar, A. Chauhan, M. Jaiswal, and D. Singh, “ETIOLOGICAL, CLINICAL AND PATHOLOGICAL PROGNOSTIC MARKERS IN HEAD AND NECK CANCERS TREATED WITH CONCURRENT CHEMO-RADIATION”, SRMsJMS, vol. 2, no. 01, pp. 36-43, Jul. 2017.