Patil V M, Noronha V, Joshi Amit, Muddu V K, Gulia S, Bhosale B, Arya S, Juvekar S, Chatturvedi P, Chaukar D A, Pai P, D'cruz A, Prabhash K
Department of Medical Oncology, Tata Memorial Hospital, Mumbai, Maharashtra, India.
Indian J Cancer. 2013 Jan-Mar;50(1):1-8. doi: 10.4103/0019-509X.112263.
Locally advanced and unresectable oral cavity cancers have a poor prognosis. Induction might be beneficial in this setting by reducing tumor bulk and allowing definitive surgery.
To analyze the impact of induction chemotherapy on locally advanced, technically unresectable oral cavity cancers.
Retrospective analysis of patients with locally advanced oral cavity cancers, who were treated with neoadjuvant chemotherapy (NACT) during the period between June 2009 and December 2010. Data from a prospectively filled database were analyzed for information on patient characteristics, chemotherapy received, toxicity, response rates, local treatment offered, patterns of failure, and overall survival. The statistical analysis was performed with SPSS version 16.
123 patients, with a median age of 42 years were analyzed. Buccal mucosa was the most common subsite (68.30%). Three drug regimen was utilized in 26 patients (21.10%) and the rest received two drug regimen. Resectability was achieved in 17 patients treated with 3 drug regimen (68.00%) and 36 patients receiving 2 drug regimen. Febrile neutropenia was seen in 3 patients (3.09%) receiving 2 drug regimen and in 9 patients (34.62%) receiving 3 drug regimen. The estimated median OS was not reached in patients who had clinical response and underwent surgery as opposed to 8 months in patients treated with non-surgical modality post NACT (P = 0.0001).
Induction chemotherapy was effective in converting technically unresectable oral cavity cancers to operable disease in approximately 40% of patients and was associated with significantly improved overall survival in comparison to nonsurgical treatment.
局部晚期且无法切除的口腔癌预后较差。诱导治疗可能通过缩小肿瘤体积并允许进行根治性手术而在这种情况下有益。
分析诱导化疗对局部晚期、技术上无法切除的口腔癌的影响。
对2009年6月至2010年12月期间接受新辅助化疗（NACT）的局部晚期口腔癌患者进行回顾性分析。分析来自前瞻性填写数据库的数据，以获取患者特征、接受的化疗、毒性、缓解率、局部治疗、失败模式和总生存的信息。使用SPSS 16版进行统计分析。
分析了123例患者，中位年龄为42岁。颊黏膜是最常见的亚部位（68.30%）。26例患者（21.10%）采用三联化疗方案，其余患者接受双联化疗方案。接受三联化疗方案的17例患者（68.00%）和接受双联化疗方案的36例患者实现了可切除性。接受双联化疗方案的3例患者（3.09%）和接受三联化疗方案的9例患者（34.62%）出现发热性中性粒细胞减少。有临床反应并接受手术的患者未达到估计的中位总生存期，而接受NACT后采用非手术治疗的患者为8个月（P = 0.0001）。
诱导化疗在约40%的患者中有效地将技术上无法切除的口腔癌转化为可手术疾病，并且与非手术治疗相比，总生存期显著改善。
