▶ Fig. 3 EUS image of a tumor of the right parapharyngeal space located between the pharyngeal wall, the medial pterygoid muscle (mpm), and the ramus of the mandible. The tumor (TU) is 34 mm × 28 mm in size, has well-delineated borders and a hypoechoic, homogeneous echo pattern. A needle passing through the pharyngeal wall into the tumor is visible. ▶ Fig. 4 Specimen obtained by EUS-guided fine-needle biopsy under 100 × magnification. Typical appearance of a pleomorphic adenoma of the parotid gland with epithelial, myoepithelial, and stromal components. Hematoxylin and eosin stain. ▶ Fig. 2 Schematic drawing of the anatomy of the mouth and throat (midsagittal plane), showing the position of the echoendoscope during endoscopic ultrasound (EUS) examination and fine-needle biopsy of the tumor. Polkowski Marcin et al. Transoral endoscopic ultrasound-guided fine-needle biopsy of a tumor of the parapharyngeal space … Endoscopy
Aim: To evaluate the role of oxaliplatin in neoadjuvant chemotherapy delivered after short-course irradiation. Background: Using oxaliplatin in the above setting is uncertain. Patients and methods: A subgroup of 136 patients managed by short-course radiotherapy and 3 cycles of consolidation chemotherapy within the framework of a randomised study was included in this post-hoc analysis. Sixty-seven patients received FOLFOX4 (oxaliplatin group) while oxaliplatin was omitted in the second period of accrual in 69 patients because of protocol amendment (fluorouracil-only group). Results: Grade 3+ acute toxicity from neoadjuvant treatment was observed in 30% of patients in the oxaliplatin group vs. 16% in the fluorouracil-only group (p = 0.053). The corresponding proportions of patients having radical surgery or achieving complete pathological response were 72% vs. 77% (odds ratio [OR] = 0.88; 95% confidence interval [CI]: 0.39-1.98; p = 0.75) and 15% vs. 7% (OR = 2.25; 95% CI: 0.83-6.94; p = 0.16), respectively. The long-term outcomes were similar in the two groups. Overall and disease-free survival rates at 5 years were 63% vs. 56% (p = 0.78) and 49% vs. 44% (p = 0.59), respectively. The corresponding numbers for cumulative incidence of local failure or distant metastases were 33% vs. 38% (hazard ratio [HR] = 0.89; 95% CI: 0.52-1.52; p = 0.68) and 33% vs. 33% (HR = 0.78; 95% CI: 0.43-1.40; p = 0.41), respectively. Conclusion: Our findings do not support adding oxaliplatin to three cycles of chemotherapy delivered after short-course irradiation.
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