Impact of 3D Radiotherapy With Cisplatin on the Eastern Cooperative Oncology Group Performance Status and Quality of Life in Terms of Acute Dermatological and Other Side Effects.

INTRODUCTION

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.

AIMS

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.

METHODOLOGY

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.

RESULTS

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.

CONCLUSION

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.