Outcomes of carboplatin-paclitaxel induction chemotherapy followed by chemoradiotherapy in locally advanced oropharyngeal and hypopharyngeal cancer: A retrospective study in a resource-limited setting

ABSTRACT Background: The role of induction chemotherapy (ICT) in locally advanced oropharyngeal and hypopharyngeal squamous cell carcinoma (SCC) remains debated, particularly in resource-limited settings. Objective: The primary objective was to evaluate the locoregional response to carboplatin- and paclitaxel-based ICT followed by concurrent chemoradiotherapy (CTRT) in patients with locally advanced oropharyngeal and hypopharyngeal SCC. The secondary objectives were to assess ICT-related adverse effects and 2-year disease-free survival and overall survival (OS). Materials and Methods: This retrospective cohort study included eligible patients who received carboplatin (AUC5) and paclitaxel (175 mg/m 2 ) as ICT between January 2018 and December 2022. Locoregional response was categorized as complete, partial, stable, or progressive. Results: Among 97 patients, 83 (85.6%) were male and 69 (71.1%) were aged > 50 years. The oropharynx was the primary site in 60 (61.9%) patients. Of the total, 61 (62.9%) received ICT + CTRT, 22 (22.7%) received only ICT, and 14 (14.4%) received ICT followed by radiation therapy. Partial response at the primary site and neck was observed in 77 (79.4%) and 67 (69.1%) patients, respectively, while a complete response at the primary site was noted in 4 (4.1%). The median (interquartile range) OS was 16.7 (11.4) months. Grade 3-4 neutropenia, thrombocytopenia, and mucositis occurred in 20 (20.6%), 18 (18.6%), and 35 (36.1%) patients, respectively. Conclusion: The carboplatin- and paclitaxel-based ICT demonstrated efficacy and tolerability and may serve as a feasible alternative to conventional triple-drug ICT for locally advanced head-and-neck SCC in resource-constrained settings. Prospective studies are warranted to validate these findings.