Preoperative radiochemotherapy and radical resection for stages II–IV oral and oropharyngeal cancer: outcome of 222 patients

Klug, Clemens; Wutzl, Arno; Kermer, Christian; Voracek, Martin; Kornek, Gabriela; Selzer, Edgar; Gläser, Christian; Poeschl, Paul W.; Millesi, W.; Ewers, Rolf

doi:10.1016/j.ijom.2004.04.003

Cited by 30 publications

(23 citation statements)

References 29 publications

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“…However, except for two previous cases [17,30] reported in the literature (one from our team), to our knowledge there is no series assessing the feasibility of neoadjuvant chemotherapy in GIIG [17]. The use of neoadjuvant chemotherapy has usually been reported for malignant neoplasias, such as breast [31], ovarian [32] and oral [33] cancers, with the aim of reducing lymphatic and microscopic dissemination, and thus optimizing surgery.…”

Section: Discussionmentioning

confidence: 99%

Combination of neoadjuvant chemotherapy followed by surgical resection as a new strategy for WHO grade II gliomas: a study of cognitive status and quality of life

et al. 2011

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Diffuse WHO grade II (GIIG) may be unresectable when involving critical structures. To assess the feasibility and functional tolerance (cognition and quality of life) of an original therapeutic strategy combining neoadjuvant chemotherapy followed by surgical resection for initially inoperable GIIG. Ten patients underwent Temozolomide for unresectable GIIG, as initial treatment or at recurrence after previous partial resection, due to invasion of eloquent areas or bi-hemispheric diffusion preventing a total/subtotal removal. Functional outcome after both treatments was assessed, with evaluation of seven cognitive domains. Chemotherapy induced tumor shrinkage (median volume decrease 38.9%) in ipsilateral functional areas in six patients and in the contralateral hemisphere in four. Only four patients had a 1p19q codeletion. The tumor shrinkage made possible the resection (mean extent of resection 93.3%, 9 total or subtotal removals) of initially inoperable tumors. Postoperatively, three patients had no deficits, while verbal episodic memory and executive functions were slightly impaired in seven patients. However, global quality of life was roughly preserved on the EORTC QLQ C30 + BN 20 (median score: 66.7%). Role functioning score was relatively reduced (median score: 66.7%) whereas KPS was preserved (median score: 90, range 80-100). Seven patients became seizure-free while three improved. This combined treatment is feasible, efficient (surgery made possible by neoadjuvant chemotherapy) and well-tolerated (preservation of quality of life, no serious cognitive disturbances). Cognitive deficits seem mostly related to tumor location. Because KPS is not reliable enough, a detailed neuropsychological assessment should be systematically performed in GIIG.

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Section: Discussionmentioning

confidence: 99%

Combination of neoadjuvant chemotherapy followed by surgical resection as a new strategy for WHO grade II gliomas: a study of cognitive status and quality of life

et al. 2011

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“…Preoperative RT, chemotherapy or a combination of these has been recently reported to be effective in advanced cases although the cases of postoperative RT or combination therapy outnumber those of preoperative concepts. These reports demonstrate that this approach is feasible with tolerable adverse events and that a high rate of completion of treatment regimen results in promising overall and disease-free survival rates 8,10,11,15,19 . In 1999, the authors reported on preoperative concurrent CRT followed by surgery for advanced OSCC and showed higher long-term survival rates of 81% at 5 and 10 years for all patients and 79% for even stage IV patients.…”

Section: Discussionmentioning

confidence: 83%

Preoperative concurrent chemoradiotherapy for stages II–IV oral squamous cell carcinoma: a retrospective analysis and the future possibility of this treatment strategy

Kirita

Yamanaka

Imai

et al. 2012

International Journal of Oral and Maxillofacial Surgery

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“…Klug et al [26], representing 222 patients, reported an overall survival of 55% after 5 years and a local control probability of 74%. Other publications regarding neoadjuvant treatment modalities report 2-year survival rates between 63 and 86% [1, 2, 13, 22,27,28,29,30].…”

Section: Discussionmentioning

confidence: 99%

Preoperative Paclitaxel/Carboplatin Radiochemotherapy for Stage III/IV Resectable Oral and Oropharyngeal Cancer: Seven-Year Follow-Up of a Phase II Trial

Eckardt

Sinikovic²,

Hofele³

et al. 2007

Oncology

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Numerous treatment concepts for advanced but resectable oral and oropharyngeal squamous cell carcinoma exist. In this study, we present the 7-year results of a promising treatment with preoperative simultaneous chemoradiation using paclitaxel and carboplatin within a prospective phase II trial comprising 56 patients. After determination of the local tumor extension, chemoradiation was applied for 4 weeks and up to 40 Gy. Following a recovery period of 3–4 weeks, tumor resection was performed within the initially tattooed resection margins, together with a functional modified neck dissection. The median follow-up time was 44.9 ± 19.6 months (range 0.76–87.9). After 7 years, 35 (63.3%) patients were alive and 20 (36.4%) had died. In 2 patients (3.6%), the cause of death was related to treatment. After 7 years, the overall survival rate declined to 63.6%, whereas the local recurrence-free probability was still 84.2%. These results confirm the excellent local control and high survival rates of preoperative radiochemotherapy with the combination of paclitaxel/carboplatin.

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Preoperative radiochemotherapy and radical resection for stages II–IV oral and oropharyngeal cancer: outcome of 222 patients

Cited by 30 publications

References 29 publications

Combination of neoadjuvant chemotherapy followed by surgical resection as a new strategy for WHO grade II gliomas: a study of cognitive status and quality of life

Combination of neoadjuvant chemotherapy followed by surgical resection as a new strategy for WHO grade II gliomas: a study of cognitive status and quality of life

Preoperative concurrent chemoradiotherapy for stages II–IV oral squamous cell carcinoma: a retrospective analysis and the future possibility of this treatment strategy

Preoperative Paclitaxel/Carboplatin Radiochemotherapy for Stage III/IV Resectable Oral and Oropharyngeal Cancer: Seven-Year Follow-Up of a Phase II Trial

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