Hamadani Aliza, Laique Talha, Ahmad Ayesha, Mahmood Aina, Mukhtar Rabia, Asim Shazia
Dermatology, Ghurki Trust Teaching Hospital, Lahore, PAK.
Pharmacology, Sahara Medical College, Narowal, PAK.
Cureus. 2025 Aug 7;17(8):e89549. doi: 10.7759/cureus.89549. eCollection 2025 Aug.
The combination of 3D radiation therapy (3D-RT) with cisplatin has been the conventional treatment for squamous cell carcinoma of the head and neck for decades.
To assess the impact of 3D radiotherapy with cisplatin on the Eastern Cooperative Oncology Group (ECOG) performance status and quality of life in terms of acute side effects among head and neck cancer patients.
After obtaining the hospital's ethical approval, 106 head and neck cancer patients were enrolled at the Institute of Nuclear Medicine and Oncology, Lahore, Pakistan. Patients of both genders who were receiving radiotherapy or chemo-radiotherapy with stage I-III head and neck cancer with ECOG statuses 1 and 2 were enrolled. All patients received 70 grays in 35 fractions, with 2 grays per fraction, after a standard treatment of 40 mg/m cisplatin once weekly for seven weeks. All patients were followed up for assessment after one month post treatment. Patients who were included were evaluated once a month after radiation therapy and at weekly intervals during treatment. SPSS version 23 software (IBM Corp., Armonk, NY) was used to analyze the data. Chi-square and Fisher's exact test were applied, while a p-value ≤ 0.05 was taken as statistically significant.
All patients experienced acute side effects after radiation therapy with cisplatin up to seven weeks into their treatment, including dermatitis, mucositis, xerostomia, and dysphagia of varying grades. After a month of treatment, however, these grade-related modifications subsided for all patients. A total of 39 patients (36.2%) had acceptable ECOG status, while 67 patients (63.8%) had poor ECOG status. An insignificant difference was observed in the frequency of acute adverse effect grades between poor and good ECOG status patients at the 1st, 4th, and 7th week of treatment. At the 11th week of treatment, the frequency of mucositis, dysphagia, and dermatitis grades between poor and good ECOG status patients showed a significant difference. The majority of the patients (n = 57, 53.8%) had a poor quality of life, while 27 (25.5%) had a good quality of life as they improved clinically.
Concurrent 3D-conformal radiotherapy with cisplatin in head and neck cancer patients is associated with significant acute dermatological and mucosal toxicities, leading to temporary deterioration in the ECOG performance status and quality of life. However, most patients showed recovery in functional status post treatment.
几十年来，三维放射治疗（3D-RT）联合顺铂一直是头颈部鳞状细胞癌的传统治疗方法。
评估三维放疗联合顺铂对东部肿瘤协作组（ECOG）体能状态以及头颈部癌症患者急性副作用方面生活质量的影响。
在获得医院伦理批准后，106名头颈部癌症患者在巴基斯坦拉合尔核医学与肿瘤研究所入组。纳入的患者为年龄、性别不限，接受放疗或放化疗，患有I-III期头颈部癌症且ECOG体能状态为1和2级的患者。所有患者在每周一次静脉注射40mg/m²顺铂，共七周的标准治疗后，接受35次分割、总量70格雷的放疗，每次分割剂量为2格雷。所有患者在治疗后一个月进行随访评估。纳入的患者在放疗后每月评估一次，治疗期间每周评估一次。使用SPSS 23版软件（IBM公司，纽约州阿蒙克）进行数据分析。采用卡方检验和Fisher精确检验，p值≤0.05被视为具有统计学意义。
所有患者在接受顺铂放疗直至治疗七周后均出现急性副作用，包括不同程度的皮炎、粘膜炎、口干和吞咽困难。然而，治疗一个月后，所有患者这些与分级相关的症状均有所缓解。共有39名患者（36.2%）的ECOG体能状态可接受，而67名患者（63.8%）的ECOG体能状态较差。在治疗第1、4和7周时，ECOG体能状态较差和较好的患者之间，急性不良反应分级的频率差异不显著。在治疗第11周时，ECOG体能状态较差和较好的患者之间，粘膜炎、吞咽困难和皮炎分级的频率存在显著差异。大多数患者（n = 57，53.8%）生活质量较差，而27名患者（25.5%）临床症状改善，生活质量良好。
头颈部癌症患者同步进行三维适形放疗和顺铂治疗会导致明显的急性皮肤和黏膜毒性，致使ECOG体能状态和生活质量暂时下降。然而，大多数患者在治疗后功能状态有所恢复。
