A combined treatment for advanced oral cavity cancers

Olasz, Lajos; Szabó, Imre; Horváth, Anna

doi:10.1002/1097-0142(19881001)62:7<1267::aid-cncr2820620704>3.0.co;2-g

Cited by 19 publications

(16 citation statements)

References 23 publications

(1 reference statement)

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“…The effectiveness of chemotherapy against SCC can be seen in different studies [28, [34][35][36]. The response rates are between 70-90%.…”

Section: Discussionsupporting

confidence: 70%

“…To compare the new BVCM with our earlier results, we developed a randomized prospective study, comparing cisplatin and BVM to a simplier standard (BVM) chemotherapy combination. According to our former conclusion there was no significant difference among clinical responses [35,43].…”

Section: Discussionmentioning

confidence: 68%

“…In the investigation of induction chemotherapy, pathologic evaluation and results are more exact and revealing than clinical responses [35,40]. Pathologically qualitative and quantitative responses can be observed.…”

Section: Discussionmentioning

confidence: 99%

“…Moreover, initial tumor size was more unfavorable in this study (70%) than in Sutton's (45%) or Woolgar's (59%) paper. The post-chemotherapy histological picture may explain the difference, where, as it was published earlier, in many cases, a fibrous scar may separate the rest tumor from the healthy tissues [27,35,40,41,43].…”

Section: Discussionmentioning

confidence: 99%

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Neoadjuvant Chemotherapy: Does It Have Benefits for the Surgeon in the Treatment of Advanced Squamous Cell Cancer of the Oral Cavity?

Olasz

Szalma

Orsi

et al. 2009

Pathol. Oncol. Res.

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The purpose of this clinicopathological study was to evaluate the effects and efficiency of combined neoadjuvant chemotherapy related to surgical margin. 100 consecutively treated squamous cell cancer patients receiving a combined neoadjuvant therapy were selected (Bleomycin-Vincristin-Methotrexate (BVM) or BVM + Mitolactol or BVM + Cisplatin). After three courses of chemotherapy, the patients were operated on. The largest diameter of the primary tumors was compared before and after chemotherapy. In the surgical specimen, the involvement of surgical margin was assessed. The largest diameter before chemotherapy was: T2 30%; T3 55%; T4A 15%. After chemotherapy, the rest tumor was assessed in the surgical specimen as: no rest 11%; <2 cm 57%; 2-4 cm 28%; 4-6 cm 4%. The no rest and <2 cm (optimal operability) tumor was observed in T2: 94%; in T3: 73%; in the T4A: 0%. Severe side effects (Grade III-IV) were not observed. There was a significant decrease in size (P < 0.0001). Of the 100 surgical specimens, 83% had clear-, 9% close- and 8% involved margins. From T4A, there was a 40% (6 patients) involved margin. Based on the significantly better size and operability of primary T2-3, the mild side effects and the high (83%) percentage of clear surgical margins, that is better than other (without preoperative chemotherapy) results, sought the use of chemotherapy is recommended before surgery. Due to the 40% involved margin, we don't suggest surgery in T4A.

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“…The effectiveness of chemotherapy against SCC can be seen in different studies [28, [34][35][36]. The response rates are between 70-90%.…”

Section: Discussionsupporting

confidence: 70%

Section: Discussionmentioning

confidence: 68%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Neoadjuvant Chemotherapy: Does It Have Benefits for the Surgeon in the Treatment of Advanced Squamous Cell Cancer of the Oral Cavity?

Olasz

Szalma

Orsi

et al. 2009

Pathol. Oncol. Res.

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“…In different studies, the stages (II-IV) are usually used for tumor size measure [5,[14][15][16], but we have not found detailed information on the possible correlation between N0 or N+ stages for chemotherapy response or recurrence rate. So far, in our earlier studies, we have not investigated these correlations [17,18].…”

Section: Introductionmentioning

confidence: 98%

Induction chemotherapy response and recurrence rates in correlation with N0 or N+ stage in oral squamous cell cancer (OSCC)

Olasz

Orsi

Markó

et al. 2010

Cancer Metastasis Rev

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The authors compared N0 with N+ cases in neoadjuvant chemotherapy regression and recurrence. During a 12-year period, 180 consecutive oral squamous cell cancer patients were observed. Of these patients, 78 were N0 and 102 N+ stages. The drugs used were as follows: bleomycin, vincristine, methotrexate, and mitolactol. After three courses of chemotherapy, the regression (complete response (CR), partial response (PR), and no response (NR)) and side effect rate were determined. All patients were operated on and observed for the number and localization of recurrences during 3 year follow-up time. The N0 cases came from T2-3, while N+ was from T2-4a (AJCC 2002). The regression in the N0 group was CR 46%, PR 53%, and NR 1%; but in the N+ group, it was CR 12%, PR 72%, and NR 16%. The regression rate was significantly higher (p = 0.00025) for N0 group than N+ group. The regression rate for T3 N0 was significantly higher (p = 0.055) than for T3 N+ cases. In the N0 stage, the regression rate was significantly higher (p = 0.0174) for T2 than T3. In N+ stage, there was no significant difference (p = 0.183) for T2-4a. The side effects were slight. The recurrence rate for the N0 group was significantly lower (15%, p = 0.000069), while for N+ group, it was 59%. The dependence in the T3 cases was also significant (p = 0.009) in the 3-year tumor-free survival. The N stage seems a more important prognostic factor for chemotherapy response and recurrence rate than the T stage. Stage III can be divided into subgroups without metastasis (III.a) and with metastasis (III.b.), based on significant difference in regression and recurrence rate.

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Induction chemotherapy with a new regimen alternating cisplatin, fluorouracil with mitomycin, hydroxyurea and bleomycin in carcinomas of nasopharynx or other sites of the head and neck region

Fountzilas

Daniilidis

Sridhar

et al. 1990

Cancer

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Sixty-six patients with locally advanced (Stages III and IV) carcinoma of the head and neck were treated with three cycles of induction chemotherapy, consisting of cisplatin, fluorouracil (FU) infusion, bleomycin, mitomycin, and hydroxyurea, followed by radiotherapy and/or surgery. There were 48 men and 18 women with a median age of 55 years (range, 18 to 75 years) and Karnofsky performance status of 80 (range, 40 to 90). Primary site was nasopharynx (28 patients), followed by larynx (12) and others (26). Forty-one (62%) patients were presented with Stage IV disease. The response rate to induction chemotherapy was 27% complete response, 50% partial response, 20% stable disease, and 3% progressive disease. There was no significant difference in response rate between patients with cancer of nasopharynx or other sites (P greater than 0.1). Survival was 61% at 24 months. Patients with cancer of nasopharynx had a better survival than those with other primaries (P = 0.033). Toxicities from chemotherapy included alopecia (73%), nausea/vomiting (66%), leukopenia (54%), stomatitis (36%), anemia (32%), thrombocytopenia (16%), and diarrhea (9%). Grade IV toxicity was not observed. Induction chemotherapy with this new regimen resulted in a high response rate but may not be superior to cisplatin and FU alone. It can be safely combined with radiotherapy as a potentially curative therapy in squamous cell carcinoma of the head and neck. Chemotherapy followed by radiation therapy may yield survival similar to radical surgery in laryngeal and other head and neck cancers.

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A combined treatment for advanced oral cavity cancers

Cited by 19 publications

References 23 publications

Neoadjuvant Chemotherapy: Does It Have Benefits for the Surgeon in the Treatment of Advanced Squamous Cell Cancer of the Oral Cavity?

Neoadjuvant Chemotherapy: Does It Have Benefits for the Surgeon in the Treatment of Advanced Squamous Cell Cancer of the Oral Cavity?

Induction chemotherapy response and recurrence rates in correlation with N0 or N+ stage in oral squamous cell cancer (OSCC)

Induction chemotherapy with a new regimen alternating cisplatin, fluorouracil with mitomycin, hydroxyurea and bleomycin in carcinomas of nasopharynx or other sites of the head and neck region

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