الفهرس 
Dedicted
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Abstract
Head and neck cancers (HNC) form the sixth most common cancer in the world with squamous cell carcinoma constituting 90% of the cases.
The present study included 102 patients with squamous cell carcinoma of the head and neck treated with radical concurrent chemoradiotherapy in South Egypt Cancer Institute and Assiut University Hospital, Clinical Oncology Department at the period from 2008 to 2009.
The patientsꞌ median age was 59 years with male to female ratio 4.1:1. The most common tumor site was the larynx in 67 patients (65.7%) followed by the oral cavity in 17 patients(16.7%) then the hypopharynx and oropharynx in 15 patients(14.7%) and 3 patients(2.9%) respectively. All patients have locally advanced disease (stage III / IV) and the most frequent histological grading was grade II.
All patients treated with concurrent chemoradiotherapy and 20 patients(19.6%)received induction chemotherapy followed by concurrent chemoradiotherapy. Different type of concurrent chemotherapy included in the study. Different radiation dosewere used with median dose of 66 Gy(mean dose of 60 Gy) and most of the patients received radiation doses of 66-70 Gy given in daily fractions of 1.8-2 Gy over 6.5-7 weeks. Regarding the radiation technique, 2DRT and 3DCRT were used.
For the whole group of patients, the loco regional tumor control after the treatment occurred in 74.5% of the patients.The one year and 2 year OS were 41.5% and 26.7% respectively,whereas the one year and 2 year PFS were 41.6% and 23% respectively.
The tumor site, stage, histopathologic grade, chemotherapy type, radiation dose, technique and radiation treatment time showed significant prognostic values by using Kaplan-Meier analysis. However, the tumor site and the technique were the only significant independent predictors to outcome on basis of cox-regression analysis.
The most common toxicities were the oral mucositis occurring in 63 patients (61.8%) followed by dysphagia occurring in 48 patients(47.1%) and skin reactions that occurring in 22 patients(21.6%). Other toxicities occurred as horseness of voice (laryngeal edema), xerostomia and chemotherapy related toxicities.