Organ-function preservation in advanced oropharynx cancer: results with induction chemotherapy and radiation.

Abstract

This treatment program is feasible and effective in patients with advanced oropharynx cancer and produces an excellent functional outcome in most long-term survivors. Modifications to optimize patient selection, minimize toxicity, and improve local control are indicated. The relative toxicity, efficacy, and functional outcome provided by this and other chemotherapy and RT programs versus either standard surgery and/or RT options can only be addressed in a randomized comparison of these therapies.

Disease control, survival, and functional outcome after multimodal treatment for advanced‐stage tongue base cancer

“…Similar studies that used primary radiotherapy demonstrate comparable results with respect to PSS scores. 7,10,30 Pfister and colleagues 20 reported on 33 patients with advanced oropharynx cancers who were treated with induction chemotherapy and radiation. The tongue base was the primary site in 31 patients.…”

“…5,8,10,11,13,19,20 Figure 1 shows our overall 2-year survival rates and 95% confidence intervals along with the 2-year survival rates interpolated from the Kaplan-Meier plots from the articles reviewed. All the survival rates from the literature were overall survival rates.…”

“…Second, the comparison data include various treatment modalities between reported groups. These methods range from primary radiotherapy with or without neck dissection, 5,8,10,19 chemoradiotherapy with surgical salvage, 20 and primary surgery with or without adjuvant radiotherapy. 11,13 None of the reports used intraoperative radiation therapy or paclitaxel as a chemotherapeutic agent.…”

“…5,8,10,11,13,19,20 A summary of these data was performed to provide a comparison of treatment results on disease control and functional status between patients treated with the intensification regimen and those reported in the literature who had more conventional treatment modalities.…”

The Role of Transoral Robotic Surgery in the Management of Oropharyngeal Squamous Cell Carcinoma: a Current Review

“…As a consequence, after the Veterans Affairs study in 1991 established an era of organ preservation in laryngeal cancer, the management strategy of oropharyngeal malignancies also shifted to non-surgical approaches. Definitive radiotherapy (RT) and chemoradiation (CRT) became the primary treatment modalities with surgery reserved for salvage therapy in efforts to obtain better organ function outcomes in patients with OPSCC [10]. However, RT and CRT are associated with many early and late toxicities including mucositis, xerostomia, loss of taste, tissue fibrosis, stricture, osteoradionecrosis, neuropathy, fatigue, and other systemic side effects which combined can yield significant long-term functional impairment [11].…”