EVALUATING THE CLINICAL OUTCOME IN HYPOPHARYNGEAL SQUAMOUS CELL CARCINOMA PATIENTS TREATED WITH CARBOPLATIN/PACLITAXEL BASED INDUCTION CHEMOTHERAPY FOLLOWED BY CONCURRENT CHEMORADIATION

Abstract

Background: Cisplatin-based chemotherapy, used either as induction therapy or concurrently with radiotherapy, remains a standard treatment option for head and neck squamous cell carcinoma.

Objective: To evaluate tumor response, treatment tolerance, disease-free survival, and progression-free survival in patients with non-metastatic hypopharyngeal squamous cell carcinoma treated with carboplatin-paclitaxel-based induction chemotherapy followed by concurrent chemoradiation.

Methodology: This single-arm prospective study included 57 patients with non-metastatic hypopharyngeal squamous cell carcinoma and conducted in Clinical and Radiation Oncology Department, Shaukat Khanum Memorial Cancer Hospital and Research Centre Peshawar from June 2025 to November 2025. Patients received carboplatin-paclitaxel-based induction chemotherapy followed by weekly concurrent chemoradiation using the same chemotherapy regimen. Treatment tolerance, compliance, and toxicity were recorded at regular intervals. Acute toxicities were assessed within 90 days from treatment initiation, while late toxicities were evaluated 6 months after completion of chemoradiation using RTOG and CTCAE grading criteria.

Results: All 57 evaluable patients received the planned treatment. Complete clinical and radiological response was observed in 29 patients (50.87%), while partial response was noted in 8 patients (14.03%). Stable disease was observed in 12 patients (21.05%), and progressive disease occurred in 8 patients (14.03%). At last follow-up, 35 patients were alive (61.4%; 95% CI: 48.4–72.9), 12 patients had died (21.05%; 95% CI: 12.5–33.3), and 10 patients were lost to follow-up (17.54%; 95% CI: 9.8–29.4). Progression-free survival at 3 and 6 months was 85.3% and 80.0%, respectively, while disease-free survival was 87.4% and 82.2%, respectively. Acute skin toxicity occurred in 36 patients (63.16%), acute dysphagia in 38 (66.66%), mucositis in 44 (77.19%), and xerostomia as late toxicity in 25 (43.85%).

Conclusion: Carboplatin-paclitaxel-based induction chemotherapy followed by concurrent chemoradiation appeared to be a tolerable and effective treatment approach for non-metastatic hypopharyngeal squamous cell carcinoma.