Role of induction chemotherapy for oral cavity squamous cell carcinoma

Abstract

Background Patients with locoregionally advanced oral cavity squamous cell carcinoma (OCSCC) have a poor survival outcome. Treatment involves extensive surgery, adjuvant radiation, or chemoradiation and results in high morbidity. In this study, the authors' objective was to evaluate their experience with induction chemotherapy (IC) in the treatment of locoregionally advanced OCSCC. Methods A retrospective review of the medical records of all patients with locoregionally advanced (stage III and IV) OCSCC who received IC followed by definitive local therapy was conducted. Outcomes included response to IC and survival. Results In total, 120 patients were included in the study. The overall stage was stage IV in 79.2% of patients. After 2 cycles of IC, 76 patients (63.3%) achieved at least a partial response, including 13 who had a complete response. Stable disease was observed in 30 patients (25%), and 14 patients (11.7%) had progressive disease. Among responders, 16 patients received definitive chemoradiation or radiation therapy, and 60 underwent surgical resection, of whom 15 had less extensive surgery than was originally planned. Overall, organ preservation was achieved in 40.8% of patients who had a favorable response to IC. The 5‐year overall and disease‐specific survival rates were 51.4% and 66.9%, respectively. Patients who had at least a partial response had better 5‐year overall survival (60.1%) and disease‐specific survival (78.5%) compared with nonresponders (33.8% and 46.4%, respectively). Conclusions The results demonstrate a response rate to IC in patients with advanced OCSCC similar to what has been observed in patients with cancer in other head and neck subsites. Patients who achieved at least a partial response to IC had a more favorable outcome, with ensuing organ preservation. Further studies are warranted.

Comparative study on hemato- and nephrotoxicity profile of weekly versus every 3-weekly cisplatin dosage during induction chemotherapy in locally advanced head neck squamous cell carcinoma

“…Majority of our patients belonged to stage III which is similar to Sahoo et al [19] and Mitra et al [21]. However, several studies reported more cases in stage IV as well [3,17,18,22,23].…”

“…Therefore, to achieve favourable outcome in such groups of patients, induction chemotherapy (IC) with ciplatin has been advocated [3,4]. As comparative data on the toxicity profile of weekly versus every 3 weeks platinumbased induction chemotherapy are lacking, we undertook this comparative study to ascertain the haematological and renal toxicity profile between these two induction chemotherapy regimens practiced in our center.…”

Neoadjuvant chemotherapy for advanced oral cavity cancer

“…16 Two newer, large nonrandomized case series confirmed the feasibility of neoadjuvant treatment to achieve high rates of organ preservation. In one review of 120 patients who received two cycles of TPF induction chemotherapy, 17 76 patients (63%) achieved a response (measured as tumor shrinkage ≥30%), including 13 (11%) who had a complete response (resolution of tumor on imaging).…”

“…Two newer, large nonrandomized case series confirmed the feasibility of neoadjuvant treatment to achieve high rates of organ preservation. In one review of 120 patients who received two cycles of TPF induction chemotherapy, 17 76 patients (63%) achieved a response (measured as tumor shrinkage ≥30%), including 13 (11%) who had a complete response (resolution of tumor on imaging). Among the 44 patients without a response, organ preservation was generally not feasible, and fewer of these patients underwent surgery compared with those who had a response (70% vs. 79%, respectively).…”

Salvianolic acid B from Salvia miltiorrhiza bunge: A potential antitumor agent

“…Surgery and chemotherapy are the conventional treatments for OSCC, with chemotherapy being the most effective ( Han et al, 2021 ; Siquara da Rocha et al, 2022 ). However, the severe side effects and resistance to chemotherapy are the biggest obstacles to treatment ( Abdelmeguid et al, 2021 ). Therefore, there is an urgent need to find novel strategies and drugs.…”