OUTCOME OF HEAD AND NECK CANCER PATIENTS MANAGED WITH CHEMORADIATION AT THE RADIOTHERAPY DEPARTMENT NATIONAL HOSPITAL ABUJA (A FIVE YEAR RETROSPECTIVE STUDY)
Background of the Study
Head and neck cancers (HNC) are malignancies that occur in the head and neck regions of the body.1 Chemoradiation is the combination of chemotherapy and radiotherapy given concurrently in the treatment of malignant cell. Addition of chemotherapy sensitize tumour cells to radiation therapy and increase locoregional control.
Research design: This was a retrospective cross sectional study.
Objectives: To determine the outcome of head and neck cancer patients managed with chemoradiation at the radiotherapy department NHA.
Methodology: Data extraction form was used to obtain Sociodemographic and clinical variables from treatment records and case notes of patients with head and neck cancer treated with chemoradiation are compared with patients who had single treatment from January, 2009 to December, 2013 at the radiotherapy department, National Hospital, Abuja. Outcomes of chemoradiation were analysed.
Results: A total of 384 cases with histologically diagnosed HNC seen during this five years period were analyzed. The mean age was 43.5 years, with a male to female ratio of 2;1, 248 males (64.6%) and 136 females (35.4%). Nasopharyngeal cancer (NPC) was the commonest type 102 (26.6%), Oral cavity 52(13.5%), Nose/paranasal
48(12.5%) and larynx 46(12.0%) cases respectively. Carcinomas made up greater than 80% of all the histologies with squamous cell carcinoma (SCC) at the fore-front, 214 (85.2%). The most frequently presented symptom was neck mass and cisplatin is the commonest chemotherapy used. Almost half of the patients 133 (42%) presented with stage IV disease, 92(29%) presented with stage III, 57(18%) presented with stage II, and 34(11%) presented with stage I disease . By the Second year of follow-up of patients that had chemoradiation , 124(39.2%) were disease free, 136 (43.3%) alive with the disease, 40 (12.6%) died of the disease, 16 (5.6%) were lost to follow-up,
The overall survival at 5 years of follow up was 24.6% for concurrent chemoradiation and 14.4% for radiotherapy alone. 7.9% were lost to follow-up probably on account of either complications of treatment, financial constraint, disease progression or unreported deaths.
Conclusion: large number of patients in our environment present with advanced stage disease and mostly aggressive which results in poor outcome. Addition of chemotherapy sensitizes tumour to radiation and increases locoregional control and there by improved treatment outcome. In this study, it was observed that, despite the late presentation, there was better outcome and improves curability compared with patients who received radiotherapy alone, this is similar to the reports in the literature review.