Lohani Sauharda, Prasai Gerim, Tandon Sarthak, Ahlawat Parveen, Antony Varghese, Bellige Akash R, Patodi Vibhor, Mahajan Shaifali, Umesh Preetha, Nayak Apoorva, Gairola Munish
Department of Radiation Oncology, Rajiv Gandhi Cancer Institute and Research Centre, Sector-5, Rohini, New Delhi, 110085 India.
Indian J Otolaryngol Head Neck Surg. 2025 Feb;77(2):960-966. doi: 10.1007/s12070-024-05315-1. Epub 2025 Jan 4.
Advanced Oral Cavity Squamous Cell Carcinoma (OSCC) poses challenges for upfront resection. While surgery followed by adjuvant treatment is standard, induction chemotherapy is explored for better resectability and organ preservation. Its efficacy in unresectable cases is still uncertain and yet to be proven. A retrospective study was done at our institute by reviewing the institutional database from January 2018 to December 2020, where patients with biopsy proven OSCC who were considered unresectable disease but treated with curative intention recruited. All the patients recruited were divided into two cohorts: Radical CCRT (Arm A) or Induction Chemotherapy (IC) followed by Chemo Radiotherapy (CCRT) (Arm B) were evaluated. The patients were analyzed for progression free survival (PFS) and Overall Survival (OS). One hundred and eighty (180) patients of locally advanced unresectable OSCC were treated with curative intent. However, data of 22 (12%) patients were excluded because of incomplete data in the database. Of remaining 158 patients, 120 (76%) and 38 (24%) were divided into arm A and B, respectively. Baseline characteristics were statistically similar in both arms except for sub site distribution with higher percentage of buccal mucosa primary [25.8% vs 42.1% in arm A vs. B respectively, ]. With a median follow-up of 16 (range 2-73) months, the Progression Free Survival (PFS) observed was 11 vs. 12 months [-value 0.460] and Overall Survival (OS) was 16 vs. 17 months [-value 0.450] in arms A and B respectively. Our study showed IC doesn't have benefit in terms of PFS or OS compared to upfront CCRT in unresectable OSCC treated in a definitive setting. However, a more robust data and literature is required to come up with a clear answer for this clinical question.
晚期口腔鳞状细胞癌（OSCC）给 upfront 切除带来了挑战。虽然手术加辅助治疗是标准方案，但人们正在探索诱导化疗以提高可切除性和器官保留率。其在不可切除病例中的疗效仍不确定，有待证实。我们研究所进行了一项回顾性研究，通过查阅 2018 年 1 月至 2020 年 12 月的机构数据库，招募了经活检证实为 OSCC 且被认为是不可切除疾病但接受了根治性治疗的患者。所有招募的患者被分为两个队列：评估根治性同步放化疗（A 组）或诱导化疗（IC）后序贯放化疗（CCRT）（B 组）。对患者进行无进展生存期（PFS）和总生存期（OS）分析。180 例局部晚期不可切除的 OSCC 患者接受了根治性治疗。然而，由于数据库中的数据不完整，22 例（12%）患者的数据被排除。在其余 158 例患者中，120 例（76%）和 38 例（24%）分别被分为 A 组和 B 组。除了原发于颊黏膜的比例不同外（A 组和 B 组分别为 25.8%和 42.1%），两组的基线特征在统计学上相似。中位随访时间为 16 个月（范围 2 - 73 个月），A 组和 B 组观察到的无进展生存期（PFS）分别为 11 个月和 12 个月[P 值 0.460]，总生存期（OS）分别为 16 个月和 17 个月[P 值 0.450]。我们的研究表明，在确定性治疗的不可切除 OSCC 中，与 upfront 同步放化疗相比，诱导化疗在无进展生存期或总生存期方面没有益处。然而，需要更有力的数据和文献才能为这个临床问题给出明确答案。
