Concurrent radiotherapy and chemotherapy for locally advanced squamous cell carcinoma of the head and neck

Background: Concurrent chemoradiation is the standard treatment for patients with advanced head and neck squamous cell carcinoma (HNSCC). The present study was carried out to assess the feasibility and efficacy of low-dose gemcitabine as a radiosensitizer when used during radical therapeutic management of patients with locally advanced HNSCC. Patients and methods: Fifty-two patients with locally advanced HNSCC (stage III, 50%; stage IVa, 50%) were enrolled during the period from July 2008 to December 2010. All received a course of radiotherapy (70 Gy over 7 weeks) concurrent with weekly infusions of gemcitabine at 50 mg/m(2). Results: All patients were available for toxicity and response. Severe mucositis (grade 3-4) was observed in 76% of patients. Severe hematological toxicity was uncommon. Xerostomia was the most common late toxicity in 34 patients (65.4%). The rate of complete and partial response rate was 67.3% and 21.1%, respectively, with an overall response rate of 88.45%. Two years progression-free survival and disease-free survival were 46% and 38.46%, respectively. Conclusion: Using low-dose gemcitabine concurrent with radiotherapy maintains high response rate with low systemic toxicity, in spite of severe mucositis in a high percentage of patients.