Hirakawa Hitoshi, Hanai Nobuhiro, Suzuki Hidenori, Nishikawa Daisuke, Matayoshi Sen, Hasegawa Yasuhisa, Suzuki Mikio
Department of Otorhinolaryngology, Head and Neck Surgery, Graduate School of Medicine, University of the Ryukyus, Nishihara-cho, Okinawa.
Department of Head and Neck Surgery, Aichi Cancer Center Hospital, Nagoya, Aichi 464-8681, Japan.
Jpn J Clin Oncol. 2017 Nov 1;47(11):1038-1046. doi: 10.1093/jjco/hyx097.
The clinical importance of neoadjuvant chemotherapy (NAC) followed by definitive surgery was retrospectively investigated in clinical Stage III/IV oral squamous cell carcinoma (OSCC).
Surgery was performed for OSCC in 164 patients, including 72 patients who had received NAC (two cycles of cisplatin and fluorouracil) prior to surgery from January 2004 to December 2014. The clinical characteristics and survival parameters of the groups that received and did not receive NAC were evaluated. The pathological response was classified as Grade 0 (no effect), 1a (very slight effect), 1b (slight effect), 2 (moderate effect) or 3 (marked effect), and its correlation with prognosis was investigated.
There were no statistical differences in survival indicators between patients who received NAC and those who did not (overall survival, P = 0.75). The proportion of patients who received NAC in the effective NAC group (Grades 1b, 2, and 3) was 52.8%. After a median follow-up of 35 months, overall survival (P = 0.01), disease-free survival (P = 0.002), locoregional disease-free survival (P = 0.003), and distant disease-free survival (P = 0.01) were significantly better in the effective NAC group than in the less effective NAC group (Grades 0 and 1a).
Although NAC had a limited effect on disease prognosis in OSCC, the pathological response to NAC could be an important prognostic indicator for advanced OSCC.
回顾性研究新辅助化疗（NAC）后行根治性手术在临床Ⅲ/Ⅳ期口腔鳞状细胞癌（OSCC）中的临床重要性。
对164例OSCC患者进行手术，其中包括2004年1月至2014年12月期间72例术前接受NAC（顺铂和氟尿嘧啶两个周期）的患者。评估接受和未接受NAC组的临床特征和生存参数。将病理反应分为0级（无效应）、1a级（非常轻微效应）、1b级（轻微效应）、2级（中度效应）或3级（显著效应），并研究其与预后的相关性。
接受NAC和未接受NAC的患者生存指标无统计学差异（总生存期，P = 0.75）。有效NAC组（1b级、2级和3级）中接受NAC的患者比例为52.8%。中位随访35个月后，有效NAC组的总生存期（P = 0.01）、无病生存期（P = 0.002）、局部区域无病生存期（P = 0.003）和远处无病生存期（P = 0.01）均显著优于低效NAC组（0级和1a级）。
尽管NAC对OSCC疾病预后的影响有限，但NAC的病理反应可能是晚期OSCC的重要预后指标。
