Retrospective analysis of surgical resection after induction chemotherapy for patients with T4b squamous cell head and neck cancer
| Autor: | Matilde Salcedo, Carmen Hinojo, Yolanda Blanco, Belen García-Montesinos, Carlos López, Maria Eugenia Vega-Villegas, Noelia Vega, Jaime Sanz-Ortiz, Marta López-Brea, Fe García-Reija, Adolfo del Valle, Fernando Rivera, Julio Rodríguez-Iglesias, Antonio Rubio, Miguel Angel Alonso-Bermejo, Raul Marquez, Sara López-Tarruella |
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| Rok vydání: | 2008 |
| Předmět: |
Adult
Male medicine.medical_specialty Cell Context (language use) Vinblastine Carboplatin Antineoplastic Combined Chemotherapy Protocols Retrospective analysis medicine Humans Radiology Nuclear Medicine and imaging Ifosfamide Uracil Aged Retrospective Studies Taxane business.industry Standard treatment Remission Induction Head and neck cancer Induction chemotherapy Vinorelbine Hematology General Medicine Middle Aged Prognosis medicine.disease Combined Modality Therapy Surgery Survival Rate medicine.anatomical_structure Oncology Head and Neck Neoplasms Concomitant Carcinoma Squamous Cell Female Cisplatin Neoplasm Recurrence Local business |
| Zdroj: | Acta Oncologica. 47:1584-1589 |
| ISSN: | 1651-226X 0284-186X |
| Popis: | Standard treatment of patients with T4b squamous cell head and neck cancer (T4b-SCHNC) is concomitant chemo-radiotherapy (CT-RT). Recent Phase III trials with Taxane containing induction chemotherapy (IC) suggest that IC could also play a role in this setting. The value of resecting the residual mass after IC and before RT is not yet clear in this context.We present the results of a retrospective analysis.Between 1984 and 2001, 113 patients (patients) with T4b-SCHNC were treated at our institution with IC. Four patients dead during IC and 57 patients achieved a complete or a90% partial response at primary and proceeded to definitive RT (or concomitant CT/RT). Surgical resection was reconsidered after IC and before RT in the other 52 patients. Surgery was performed in 13 of them: in 7 patients resection was R1, all of them had loco-regional progression (2 also developed systemic metastases) and median OS after surgery was 21 months, with no patient alive at 48 months. In the other 6 patients a R0 resection was performed: 3 of these patients had loco-regional relapses (1 also developed systemic metastases) and the other 3 patients remain alive and disease free 56, 62 and 72 months after surgery. Considering the 52 patients that achieved less than a 90% partial response at primary with IC, overall survival was equivalent when no Resection or an R1 resection was performed after IC (5 year OS 8 vs. 0%, lrk, p=0.74), but a statistically significant improvement in OS was observed when an R0 resection was obtained (5 years OS 50%, lrk, p=0.02).R0 resections after IC and before RT could indicate an improvement in OS in patients with T4b-SCHNC that obtain less than a 90% PR at primary after IC. We consider that this approach deserves further research in prospective clinical trials. |
| Databáze: | OpenAIRE |
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