Department of Head and Neck Surgery, The University of Texas MD Anderson Cancer Center, Houston, Texas.
Department of Otolaryngology Head and Neck Surgery, Faculty of Medicine, Mansoura University, Mansoura, Egypt.
Cancer. 2021 Sep 1;127(17):3107-3112. doi: 10.1002/cncr.33616. Epub 2021 Apr 28.
Patients with locoregionally advanced oral cavity squamous cell carcinoma (OCSCC) have a poor survival outcome. Treatment involves extensive surgery, adjuvant radiation, or chemoradiation and results in high morbidity. In this study, the authors' objective was to evaluate their experience with induction chemotherapy (IC) in the treatment of locoregionally advanced OCSCC.
A retrospective review of the medical records of all patients with locoregionally advanced (stage III and IV) OCSCC who received IC followed by definitive local therapy was conducted. Outcomes included response to IC and survival.
In total, 120 patients were included in the study. The overall stage was stage IV in 79.2% of patients. After 2 cycles of IC, 76 patients (63.3%) achieved at least a partial response, including 13 who had a complete response. Stable disease was observed in 30 patients (25%), and 14 patients (11.7%) had progressive disease. Among responders, 16 patients received definitive chemoradiation or radiation therapy, and 60 underwent surgical resection, of whom 15 had less extensive surgery than was originally planned. Overall, organ preservation was achieved in 40.8% of patients who had a favorable response to IC. The 5-year overall and disease-specific survival rates were 51.4% and 66.9%, respectively. Patients who had at least a partial response had better 5-year overall survival (60.1%) and disease-specific survival (78.5%) compared with nonresponders (33.8% and 46.4%, respectively).
The results demonstrate a response rate to IC in patients with advanced OCSCC similar to what has been observed in patients with cancer in other head and neck subsites. Patients who achieved at least a partial response to IC had a more favorable outcome, with ensuing organ preservation. Further studies are warranted.
局部晚期口腔鳞状细胞癌（OCSCC）患者的生存预后较差。治疗包括广泛的手术、辅助放疗或放化疗，导致高发病率。在这项研究中，作者的目的是评估诱导化疗（IC）在局部晚期 OCSCC 治疗中的应用经验。
对所有接受 IC 治疗后行确定性局部治疗的局部晚期（III 期和 IV 期）OCSCC 患者的病历进行回顾性分析。结局包括 IC 反应和生存情况。
共纳入 120 例患者。79.2%的患者总体分期为 IV 期。在 2 个周期 IC 后，76 例（63.3%）患者至少有部分缓解，包括 13 例完全缓解。30 例（25%）患者病情稳定，14 例（11.7%）疾病进展。在应答者中，16 例患者接受了确定性放化疗或放疗，60 例行手术切除，其中 15 例患者的手术范围比原计划小。总体而言，对 IC 有良好反应的患者中有 40.8%实现了器官保存。5 年总生存率和疾病特异性生存率分别为 51.4%和 66.9%。与无应答者相比（分别为 33.8%和 46.4%），至少部分缓解的患者具有更好的 5 年总生存率（60.1%）和疾病特异性生存率（78.5%）。
结果表明，晚期 OCSCC 患者对 IC 的反应率与其他头颈部亚部位癌症患者相似。对 IC 至少有部分缓解的患者具有更好的预后，从而实现器官保存。需要进一步的研究。
