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Comparison of cisplatin-based combination chemotherapy with carboplatin-based combination chemotherapy in oral and pharyngeal cancers: an observatory pilot study

Vibha Dhruw, Hemlata Thakur, Lakhan Singh.


Background: Oral and pharyngeal cancers are one of the most prevalent category of cancers worldwide. These kinds of cancers are associated with poor outcomes in terms of quality of life and mortality. The main modality of treatment is chemotherapy, and combination therapy based on cisplatin is commonly used. Cisplatin is associated with severe side effects, and there are some studies that revealed that carboplatin can be a good alternative to cisplatin.

Objective: To compare cisplatin-based chemotherapy with carboplatin-based combination therapy in grades III and IV oral cancers.

Materials and Methods: This is an observational study based on the patients of a tertiary-care center. The subjects were categorized into two groups based on the treatment regimen prescribed to them. Group I was administered intravenous (IV) paclitaxel (175 mg/m2) and IV cisplatin (70 mg/m2) on day 1 and IV 5-fluorouracil (FU; 1,200 mg/m2) from days 2 to 4. This regimen was repeated after 21 days. A total of six cycles were completed. Group 2 was administered IV paclitaxel (175 mg/m2) on day 1, IV carboplatin (dose calculated on AUC), and IV 5-FU (1,200 mg/m2) from days 2 to 4. This regimen was repeated after 21 days, and such six such cycles were completed. Both the groups were compared for recovery and adverse effects after the completion of the study period.

Result: There was no significant difference in recovery between both the groups (p = 0.56, X2 = 1.12, df = 2). Adverse effects were more in the cisplatin group when compared with those in the carboplatin group. The most common adverse effects were nausea and vomiting, mucositis, and renal complications.

Conclusion: There is no significant difference in efficacy between cisplatin and carboplatin, but carboplatin is safe when compared with cisplatin. Small sample size and observatory nature of the study are the serious limitations for interpretation of these results.

Key words: Cisplatin, carboplatin, oral cancer, pharyngeal cancer

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