Induction chemotherapy and radiation therapy for T4 oropharyngeal carcinoma

Nathu, Rakesh M.; Mendenhall, William M.; Parsons, James T.; Mancuso, Anthony A.; Carroll, Robert R.

doi:10.1002/(sici)1520-6823(1999)7:2<98::aid-roi5>3.3.co;2-2

Cited by 3 publications

(3 citation statements)

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“…Of interest when advocating such a strategy are two reports. In the first one, Nahu 11 et al in 1999, in a retrospective analysis of 123 T4 SCC of the oropharynx, noted that the 5-year actuarial local control estimate increased significantly from 38% to 63% when an induction chemotherapy regimen was used prior to radiation therapy. In the second one, Finnegan 12 et al in 2009, in a retrospective analysis of 23 patients with oropharyngeal SCC classified as T3 to T4 originating from the tongue base or the tonsillar region in 95.6% of cases, noted that the completion of a platin-based induction chemotherapy regimen followed by hyperfractionated radiation therapy with concurrent chemotherapy resulted in a 55% 5-year absolute survival rate and an overall 89% local control rate.…”

Section: Discussionmentioning

confidence: 99%

Lateral pharyngotomy for selected invasive squamous cell carcinoma of the lateral oropharynx. Part II: When and why

Laccourreye

Benito

Garcia³

et al. 2013

The Laryngoscope

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Section: Discussionmentioning

confidence: 99%

Lateral pharyngotomy for selected invasive squamous cell carcinoma of the lateral oropharynx. Part II: When and why

Laccourreye

Benito

Garcia³

et al. 2013

The Laryngoscope

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“…Neoadjuvant chemotherapy before RT is an effective organ‐ sparing strategy for patients with SCC of the larynx 76 and hypopharynx 77, 78 and showed promise as an organ‐sparing tool in a retrospective analysis of patients with T4 oropharyngeal SCC at the University of Florida. 79 Concurrent chemotherapy and RT regimens have consistently produced higher rates of both local‐regional control and survival compared with the rates produced by RT alone in randomized trials 80–85 and hold promise for continued improvement in both tumor control and functional outcome.…”

Section: Discussionmentioning

confidence: 99%

Squamous cell carcinoma of the oropharynx

Parsons

Mendenhall

Stringer

et al. 2002

Cancer

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404

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BACKGROUND The treatment of patients with squamous cell carcinoma (SCC) of the oropharynx remains controversial. No randomized trial has addressed adequately the question of whether surgery (S), radiation therapy (RT), or combined treatment is most effective. METHODS Treatment results from North American academic institutions that used S with or without adjuvant RT (S ± RT) or used RT alone or followed by neck dissection (RT ± ND) for patients with SCC of the tonsillar region or the base of tongue were compiled through a MEDLINE search (from 1970 to August, 2000) and from the references cited in each report. Studies were eligible for inclusion if they contained direct, actuarial (life‐table), or Kaplan–Meier calculations for the following end points: local control, local‐regional control, 5‐year absolute survival, 5‐year cause specific survival, or severe or fatal treatment complications. Weighted average results, which took into account series size, were calculated for each end point for the purposes of treatment comparison. Results and conclusions were based on data from 51 reported series, representing the treatment of approximately 6400 patients from the United States and Canada. RESULTS The results for patients with SCC of the base of tongue who underwent S ± RT versus RT ± ND, respectively, were as follows: local control, 79% versus 76% (P = 0.087); local‐regional control, 60% versus 69% (P = 0.009); 5‐year survival, 49% versus 52% (P = 0.2); 5‐year cause specific survival, 62% versus 63% (P = 0.4); severe complications, 32% versus 3.8% (P < 0.001); and fatal complications, 3.5% versus 0.4% (P < 0.001). The results for patients with SCC in the tonsillar region who underwent S ± RT versus RT ± ND, respectively, were as follows: local control, 70% versus 68% (P = 0.2); local‐regional control, 65% versus 69% (P = 0.1); 5‐year survival, 47% versus 43% (P = 0.2); 5‐year cause specific survival, 57% versus 59% (P = 0.3); severe complications, 23% versus 6% (P < 0.001); and fatal complications, 3.2% versus 0.8% (P < 0.001). CONCLUSIONS The information in this article provides a useful benchmark for evidence‐based counseling of patients with SCC of the oropharynx. The rates of local control, local‐regional control, 5‐year survival, and 5‐year cause specific survival were similar for patients who underwent S ± RT or RT ± ND, whereas the rates of severe or fatal complications were significantly greater for the S ± RT group. Furthermore, available data on the functional consequences of treatment suggest the superiority of RT ± ND. The authors conclude that RT ± ND is preferable for the majority of patients with SCC of the oropharynx. Cancer 2002;94:2967–80. © 2002 American Cancer Society. DOI 10.1002/cncr.10567

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“…Patients with advanced N2 and N3 disease usually underwent a planned neck dissection after RT, as did those with earlier stage neck disease that did not completely resolve at the end of RT 20. Induction chemotherapy was given to 28 patients with advanced disease before November 1997 and usually consisted of two to three cycles of fluorouracil and cisplatin 21–23. Thereafter, patients with unfavorable T3 and T4 cancers who were medically fit were offered concomitant chemotherapy,24–29 which consisted of either two cycles of fluorouracil and cisplatin, daily cisplatin (6 mg/m 2 ) throughout the RT course, or weekly cisplatin (30–40 mg/m 2 ).…”

Section: Methodsmentioning

confidence: 99%