Primary Chemotherapy in Resectable Oral Cavity Squamous Cell Cancer: A Randomized Controlled Trial

Licitra, Lisa; Grandi, Cesare; Guzzo, Marco; Mariani, Luigi; Vullo, Salvatore Lo; Valvo, Francesca; Quattrone, Pasquale; Valagussa, Pinuccia; Bonadonna, Gianni; Molinari, Roberto; Cantù, Giulio

doi:10.1200/jco.2003.06.146

Cited by 243 publications

(172 citation statements)

References 30 publications

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“…NAC, which is the use of systemic chemotherapy before definitive surgery and/or radiotherapy, is an attractive approach in the management of HNSCC. The benefits of NAC for patients with locally advanced head and neck cancer, as demonstrated by several clinical studies, include a reduction in distant metastasis and the preservation of organ function (48-51); however, NAC has failed to demonstrate any significant improvement of survival in several randomized control trials (49,50). The efficacy of NAC is controversial, and no report supports NAC with a high evidence level.…”

Section: Local Recurrence -------------------------------------------mentioning

confidence: 99%

Expression of the cancer stem cell markers CD44v6 and ABCG2 in tongue cancer: Effect of neoadjuvant chemotherapy on local recurrence

Yanamoto

Yamada

Takahashi

et al. 2014

International Journal of Oncology

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Abstract. The efficacy of neoadjuvant chemotherapy (NAC) is controversial, and no report supports NAC with a high evidence level. Recently, we showed that a deep surgical margin was resected very close to the tumor site in many NAC-treated oral squamous cell carcinoma patients, suggesting that NAC may lead to local recurrence and poor outcomes. The purpose of this study was to evaluate the effect of NAC on tumor local recurrence using cancer stem cell marker immunohistochemistry. We retrospectively analyzed 89 patients who underwent radical surgery for tongue cancer, and examined the effect of NAC on tumor local recurrence. Cancer stem cell marker (CD44v6 and ABCG2) expression was detected by immunohistochemistry. In our study, the local recurrence rate was 12.4%. CD44v6 and ABCG2 expression was significantly associated with regional lymph node metastasis, pattern of invasion, depth of invasion, perineural invasion and local recurrence, respectively. Tumor local recurrence was a significant independent predictive factor of the 5-year disease specific survival. CD44v6 or ABCG2 positivity in NAC-treated patients was significantly associated with tumor local recurrence. It was suggested that local recurrence in NAC-treated cases is associated with cancer stem-like cells. We propose that NAC leads to the selection and/or residue of more aggressive cancer stem-like cells.

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Section: Local Recurrence -------------------------------------------mentioning

confidence: 99%

Expression of the cancer stem cell markers CD44v6 and ABCG2 in tongue cancer: Effect of neoadjuvant chemotherapy on local recurrence

Yanamoto

Yamada

Takahashi

et al. 2014

International Journal of Oncology

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“…Before the era of taxane, induction treatment did not confer a survival benefit despite its high response (8,9). However, the present result with including docetaxel in the regime offers an advantage over standard PF for the toxicity and convenience.…”

Section: Discussionmentioning

confidence: 99%

Induction Chemotherapy of Docetaxel and Cisplatin for the Elderly Patients with Squamous Cell Carcinoma of the Head and Neck

et al. 2007

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Purpose: Although concurrent chemoradiotherapy (CCRT) has been considered as a standard treatment for locally advanced squamous cell carcinoma of the head and neck (SCCHN), this treament is associated with increased toxicities such as mucositis and dermatitis. As a result, the dose intensity can be reduced and interruptions of radiotherapy are more common for CCRT than for sequential treatment, especially for the elderly patients. This prospective study was performed to assess the efficacy and safety profiles of the induction chemotherapy of docetaxel and cisplatin for elderly patients with locally advanced SCCHN.

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“…At present, the standard treatment for oral cancer remains surgery alone, with radiotherapy or concomitant chemoradiotherapy subsequent to surgery recommended for high-risk cases (32), as pre-operative chemotherapy has failed to significantly improve the OS rate in certain previous randomized controlled trials (33,34). 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).…”

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

confidence: 99%

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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Primary Chemotherapy in Resectable Oral Cavity Squamous Cell Cancer: A Randomized Controlled Trial

Cited by 243 publications

References 30 publications

Expression of the cancer stem cell markers CD44v6 and ABCG2 in tongue cancer: Effect of neoadjuvant chemotherapy on local recurrence

Expression of the cancer stem cell markers CD44v6 and ABCG2 in tongue cancer: Effect of neoadjuvant chemotherapy on local recurrence

Induction Chemotherapy of Docetaxel and Cisplatin for the Elderly Patients with Squamous Cell Carcinoma of the Head and Neck

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

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