Hyperfractionated radiotherapy with concurrent weekly paclitaxel and carboplatin for locally advanced unresectable head and neck squamous cell carcinoma

Background: Squamous cell carcinoma of the head and neck (HNSCC) is a major contributor to cancer-related morbidity and mortality worldwide, with particularly high incidence rates in India and Tamil Nadu. Locally advanced, unresectable HNSCC presents a significant therapeutic challenge. This study aimed to assess the immediate loco-regional response rates following treatment with hyperfractionated radiotherapy combined with concurrent weekly paclitaxel and carboplatin, as well as to evaluate acute toxicity and prognostic factors influencing treatment outcomes. Methods: A cross-sectional study was conducted involving 30 patients with biopsy-confirmed stage III or IV unresectable HNSCC. All patients received hyperfractionated radiotherapy (72 Gy in 120 cGy per fraction, twice daily) concurrently with weekly paclitaxel (40 mg/m²) and carboplatin (AUC = 1). Supportive care included nutritional support, smoking cessation counseling, and dental care. Treatment response was assessed using CT scans and RECIST criteria. Results: The study observed favorable loco-regional control, with most patients achieving either partial or complete responses. Acute toxicity was manageable, with mucositis, xerostomia, and dysphagia being the most frequently reported side effects. Tumor size and patient performance status were significant prognostic indicators of treatment response. Conclusion: Hyperfractionated radiotherapy combined with concurrent paclitaxel and carboplatin demonstrates encouraging loco-regional control and acceptable toxicity in patients with locally advanced, unresectable HNSCC. These findings support its use as an effective therapeutic option; however, further studies with larger sample sizes are needed to validate these outcomes and refine treatment strategies.