Treatment Approaches in Inoperable Head and Neck Squamous Cell Carcinoma: Concurrent vs. Sequential Chemoradiotherapy

Abstract

Background: Inoperable head and neck squamous cell carcinoma (HNSCC) poses a formidable challenge in oncology due to limited treatment options and unfavorable prognosis. Concurrent and sequential chemoradiotherapy have emerged as key therapeutic modalities, but their relative efficacy remains a topic of debate. Objective: This study aimed to compare the effectiveness of concurrent versus sequential chemoradiotherapy in the management of inoperable HNSCC, with a focus on treatment outcomes and toxicity profiles. Method: A retrospective analysis was conducted at Department of Radiotherapy, Rajshahi Medical College Hospital Bangladesh, over one year from June 1, 2019, to December 31, 2020. A total number of 96 patients diagnosed. Patients were divided into two groups based on the treatment approach received: concurrent chemoradiotherapy (n=48) and sequential chemoradiotherapy (n=48). Result: The study was found that concurrent chemoradiotherapy associated with significantly higher rates of locoregional control compared to sequential chemoradiotherapy (78% vs. 65%, p<0.05). Similarly, overall survival rates were superior in the concurrent therapy group, with a median survival of 24 months compared to 18 months in the sequential therapy group (p<0.05). However, concurrent chemoradiotherapy was also associated with a higher incidence of acute toxicities, including mucositis (60% vs. 45%, p<0.05) and dysphagia (55% vs. 40%, p<0.05), compared to sequential therapy. Conclusion: Concurrent chemoradiotherapy demonstrates superior locoregional control and overall survival outcomes compared to sequential chemoradiotherapy in the management of inoperable HNSCC.