Medical Oncology Department, Hospital da Senhora da Oliveira, Guimarães, Portugal.
Surgical Oncology, Instituto Português de Oncologia do Porto Francisco Gentil, Porto, Portugal.
Tumori. 2024 Oct;110(5):340-347. doi: 10.1177/03008916241257099. Epub 2024 Jun 2.
Induction chemotherapy has been described as an option in locally advanced oral cavity squamous cell carcinoma when the surgical morbidity is expected to be high. This work aimed to evaluate the outcome and safety of induction chemotherapy in this setting.
We performed a retrospective and observational study including patients with oral cavity squamous cell carcinoma, treated with induction chemotherapy between January 2010 and December 2018. Outcomes included induction chemotherapy toxicity, treatment response, disease-free survival and overall survival.
A total of 108 oral cavity squamous cell carcinoma patients were included. Ninety-six (88.9%) had stage IV disease, while 12 (11.1%) had stage III. Eighty-four patients (80.8%) achieved at least a partial response to induction chemotherapy at clinical evaluation, and 75 (72.1%) at radiological evaluation. Seventy-eight patients have been proposed for subsequent definitive treatments, with no differences obtained in prognosis, when comparing surgical to non-surgical approaches. In patients treated with definitive treatments, improved five-year disease-free survival was obtained if at least a clinical (56.3%; p=0.001) or radiological (52.9%; p=0.001) partial response was achieved after induction chemotherapy. Similarly, superior five-year overall survival was verified for those achieving at least clinical (51.1%; p<0.0001) or radiological (52.6%; p=0.001) partial response. Also, accomplishing a pathologic complete response (n=22.6%) significantly improved disease-free survival (p=0.039) and overall survival (p=0.005). Grade 3 and 4 toxicities were observed in 52 patients (41.8%).
Responses to induction chemotherapy predicted prognosis in our population, however important toxicities were observed. Further studies are necessary to identify induction chemotherapy response predictors and subgroups who may benefit from this approach.
当预计手术发病率较高时，诱导化疗已被描述为局部晚期口腔鳞状细胞癌的一种选择。本研究旨在评估该情况下诱导化疗的结果和安全性。
我们进行了一项回顾性观察性研究，纳入了 2010 年 1 月至 2018 年 12 月期间接受诱导化疗的口腔鳞状细胞癌患者。结果包括诱导化疗毒性、治疗反应、无病生存和总生存。
共纳入 108 例口腔鳞状细胞癌患者。96 例（88.9%）为 IV 期疾病，12 例（11.1%）为 III 期。84 例（80.8%）患者在临床评估时至少获得部分缓解，75 例（72.1%）在放射学评估时获得部分缓解。78 例患者被建议进行后续确定性治疗，手术和非手术方法的预后无差异。在接受确定性治疗的患者中，如果在诱导化疗后至少获得临床（56.3%；p=0.001）或放射学（52.9%；p=0.001）部分缓解，则获得了改善的五年无病生存率。同样，如果至少获得临床（51.1%；p<0.0001）或放射学（52.6%；p=0.001）部分缓解，则获得了更好的五年总生存率。此外，实现病理完全缓解（n=22.6%）显著改善了无病生存率（p=0.039）和总生存率（p=0.005）。观察到 52 例（41.8%）患者出现 3 级和 4 级毒性。
我们人群中诱导化疗的反应预测了预后，但观察到了重要的毒性。需要进一步的研究来确定诱导化疗反应的预测因子和可能从该方法中受益的亚组。
