Preoperative induction chemotherapy followed by concurrent chemoradiotherapy in advanced carcinoma of the oral cavity and oropharynx

Giralt, Jordi; Gonzalez, Javier; Campo, J. M. Del; Maldonado, J; Sanz, X.; Romero, J. Pamias; Eraso, Aranzazu; Bescos, S.; Raspall, G.

doi:10.1002/1097-0142(20000901)89:5<939::aid-cncr1>3.0.co;2-6

Cited by 37 publications

(33 citation statements)

References 30 publications

(30 reference statements)

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“…Although the results of the outcomes in this study support the findings of previous reports (Shaha et al 1984;Hicks et al 1997;Sessions et al 2000), we emphasize that the patient outcome for surgery in our patients was almost equal to, or better than those of previous reports (Hicks et al 1997;Sessions et al 2000;Diaz et al 2003) and this study contained some intensive CRT patients, such as iaCDDP (Doweck et al 2008), CF (Giralt et al 2000), and DCF (Tsukuda et al 2010).…”

Section: Discussionsupporting

confidence: 80%

Surgical Treatment Is Recommended for Advanced Oral Squamous Cell Carcinoma

Ogawa

Matsuura

Shiga

et al. 2011

Tohoku J. Exp. Med.

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Oral squamous cell carcinoma is one of the most frequent types of head and neck cancers in Japan. Although recent reports have shown positive results of non-surgical treatment for advanced head and neck squamous cell carcinoma, including tongue cancer, no clear treatment strategies have been established for oral cancers, except for tongue cancer. To assess appropriate therapies, we conducted a retrospective chart review of 114 Japanese patients with oral cancers that were pathologically diagnosed as squamous cell carcinoma, excluding tongue cancers. The overall and the disease specific 5-year survival rates were 53% and 61%, respectively. Univariate and multivariate analyses revealed a lower stage (I, II, or III) and non-surgical treatment as good and poor prognostic factors of oral squamous cell carcinoma, respectively, based on their hazard ratios of 0.17 (95% CI 0.045-0.60, p = 0.0061) and 5.3 (95% CI 2.7-11, p < 0.0001). Furthermore, impact of surgery was well documented in the operable stage IVa cancers (p = 0.00015). The surgical treatment consisted of the wide resection of the primary tumor and the neck dissection for stage III or IV tumors. The present data also suggest that adjunctive therapy, such as post-operative radiation therapy or post-operative chemo-radiation therapy, shows no survival benefit compared to the surgery alone. We therefore recommend the surgical treatment for advanced oral squamous cell carcinoma in Japanese patients. These results would be helpful in future clinical trials, especially in non-surgical treatment studies of oral squamous cell carcinoma in Japan.

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Section: Discussionsupporting

confidence: 80%

Surgical Treatment Is Recommended for Advanced Oral Squamous Cell Carcinoma

Ogawa

Matsuura

Shiga

et al. 2011

Tohoku J. Exp. Med.

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“…In the patients with stage III/IV OSCC in the present study, the histopathological response rate was 63.5% (data not shown), which was decreased compared with the response rate of previous studies. However, the OS rate of the patients with stage III/IV OSCC in the present study was 84.0%, which yielded a similar survival curve to those obtained in previous studies (6)(7)(8)(9)23,24). Miyawaki et al demonstrated that the administration of S-1 chemoradiotherapy at 30 Gy to treat OSCC at stages II-IV, which was similar to the present regimen, was histopathologically effective in 73.7% of patients (30).…”

Section: Histopathological Response N ------------------------------supporting

confidence: 89%

“…In addition, Yanamoto et al hypothesized that neoadjuvant chemotherapy may increase the risk of local recurrence and lead to poor outcomes in OSCC patients (35). Overall, promising results were obtained in the present study, although limited by its retrospective nature, and in other similar studies (6)(7)(8)(9)23,24,27). However, the efficacy of pre-operative chemoradiotherapy remains controversial, and a definitive conclusion cannot yet be reached.…”

Section: Histopathological Response N ------------------------------mentioning

confidence: 47%

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Clinicopathological evaluation of pre-operative chemoradiotherapy with S-1 as a treatment for locally advanced oral squamous cell carcinoma

et al. 2016

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Abstract. The administration of pre-operative chemotherapy with S-1 and concurrent radiotherapy at a total dose of 30 Gy was clinicopathologically evaluated as a treatment for locally advanced oral squamous cell carcinoma (OSCC) in the present study. The participants comprised 81 patients with OSCC, consisting of 29 patients with stage II disease, 12 patients with stage III disease and 40 patients with stage IV disease. All patients received a total radiation dose of 30 Gy in daily fractions of 2 Gy, 5 times a week, for 3 weeks, and the patients were concurrently administered S-1 at a dose of 80-120 mg, twice daily, over 4 consecutive weeks. Radical surgery was performed in all cases at 2-6 weeks subsequent to the end of pre-operative chemoradiotherapy. The most common adverse event was oropharyngeal mucositis, but this was transient in all patients. No severe hematological or non-hematological toxicities were observed. The clinical and histopathological response rates were 70.4 and 75.3%, respectively. Post-operatively, local failure developed in 6 patients (7.4%) and neck failure developed in 2 patients (2.5%). Distant metastases were found in 7 patients (8.6%). The overall survival rate, disease-specific survival rate and locoregional control rate at 5 years were 87.7, 89.9 and 90.6%, respectively. Locoregional recurrence occurred more frequently in patients that demonstrated a poor histopathological response compared with patients that demonstrated a good response (P<0.01). These results indicate that pre-operative S-1 chemotherapy with radiotherapy at a total dose of 30 Gy is feasible and effective for patients with locally advanced OSCC, and that little or no histopathological response may be a risk factor for locoregional recurrence in this treatment. IntroductionOral squamous cell carcinoma (OSCC) accounts for ~3% of all malignancies worldwide (1). Despite this low frequency of occurrence, the 5-year overall survival rate of patients with OSCC has not exceeded 55% over the previous decade, due to the local aggressiveness and high recurrence rate of the disease (2). Advanced OSCC remains refractory and results in mortality in >50% of cases (1).Complete locoregional control is crucial in the treatment of OSCC, as distant metastases are rarely identified at the initial presentation (3). Therefore, multimodal treatment has typically been implemented for advanced OSCC in order to control locoregional disease, generally consisting of radical surgery followed by radiotherapy (4). The issue with this combined therapeutic approach is the high recurrence rate at primary or regional sites within the first 2 years subsequent to treatment (5). As a result, 5-year survival rates have been low in patients treated with this therapy (5).Pre-operative chemoradiotherapy has become an established component of the clinical management of locoregionally advanced operable OSCC (6-10). Kirita et al has previously reported that pre-operative cisplatin (CDDP)-based intravenous chemotherapy and concurrent radiotherapy (total dose, ...

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“…15 Patients underwent posttherapy biopsy or organ preservation surgery, depending on response. Although function was not studied, the authors found that there was organ preservation in 60% and that 75% of these patients were disease free at 3 years.…”

Section: Discussionmentioning

confidence: 99%

Chemoradiation for patients with advanced oral cavity cancer

Stenson¹,

Kunnavakkam²,

Cohen³

et al. 2009

The Laryngoscope

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Objectives/Hypothesis:Patients with advanced oral cavity cancer (OCC) typically have not been enrolled in clinical trials utilizing contemporary multimodality strategies. There exist dogmatic expectations of inferior outcome in OCC patients secondary to ineffectiveness of treatment and unacceptable toxicity. The purpose of this study was to analyze survival, swallowing function, and incidence of osteoradionecrosis (ORN) of patients with stage III/IV OCC who have undergone primary concomitant chemoradiotherapy (CRT).Methods:All advanced OCC patients who were enrolled in University of Chicago concomitant CRT protocols from 1994 to 2008 were reviewed. One hundred eleven newly diagnosed advanced OCC patients were evaluated. We performed a subset analysis of 27 additional advanced OCC patients who underwent surgery followed by postoperative CRT. Swallowing function was assessed via oropharyngeal motility study, and a Swallowing Performance Status Scale score was assigned. Presence of clinically significant ORN was documented.Results:Median follow‐up was 3.25 years. Five‐year overall and progression‐free survival was 66.9% and 65.9%, respectively. There was no difference in overall or progression‐free survival when the surgery‐first group was compared with the primary CRT group (P = .88 and P = .86 respectively). Function, without gastric tube requirement, was excellent, with 92.2% of patients able to maintain weight via oral route. Incidence of ORN was 18.4%, occurring in nine of 49 patients evaluated.Conclusions:Our data support the use of primary CRT as a viable treatment option for patients with advanced OCC. Survival is high, and overall function for the majority of patients is satisfactory. Patients with T4 oral tongue cancer may be spared total glossectomy. The incidence of ORN may be considered acceptable, in light of the benefits of enduring life and function. Laryngoscope, 2010

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Preoperative induction chemotherapy followed by concurrent chemoradiotherapy in advanced carcinoma of the oral cavity and oropharynx

Cited by 37 publications

References 30 publications

Surgical Treatment Is Recommended for Advanced Oral Squamous Cell Carcinoma

Surgical Treatment Is Recommended for Advanced Oral Squamous Cell Carcinoma

Clinicopathological evaluation of pre-operative chemoradiotherapy with S-1 as a treatment for locally advanced oral squamous cell carcinoma

Chemoradiation for patients with advanced oral cavity cancer

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