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. 2017 Oct-Dec;38(4):490-494.
doi: 10.4103/ijmpo.ijmpo_185_16.

Induction Chemotherapy in Technically Unresectable Locally Advanced T4a Oral Cavity Squamous Cell Cancers: Experience from a Regional Cancer Center of South India

A H Rudresha  1 , Tamojit Chaudhuri  1 , K C Lakshmaiah  1 , K Govind Babu  1 , Lokanatha Dasappa  1 , Linu Abraham Jacob  1 , M C Suresh Babu  1 , K N Lokesh  1 , L K Rajeev  1
Affiliations

Induction Chemotherapy in Technically Unresectable Locally Advanced T4a Oral Cavity Squamous Cell Cancers: Experience from a Regional Cancer Center of South India

A H Rudresha et al. Indian J Med Paediatr Oncol. 2017 Oct-Dec.

Abstract

Objectives: The present study aimed to investigate the efficacy, toxicity, and impact of induction chemotherapy (IC) in technically unresectable T4a oral cavity squamous cell cancers (OSCCs).

Materials and methods: Patients diagnosed with technically unresectable locally advanced T4a OSCC from January 2013 and November 2016 at our center, who received 2-3 cycles of IC and then assessed for resectability, were reviewed retrospectively. Patients' profile, response rates and toxicity of IC, resectability status, and overall survival (OS) were evaluated. Statistical analyses were performed using SPSS version 17.0 for Windows (SPSS Inc., Chicago, IL, USA).

Results: Totally 80 patients received IC, and of them 58 (72.5%) were males. Median age at diagnosis was 44 years (range, 34-62 years). All our patients received IC with doublet regimen. Majority of the patients had buccal mucosa cancers (73.8%), followed by gingivobuccal complex (21.2%) and oral tongue (5%) primaries. After IC, partial response was achieved in 17 (21.3%) patients, stable disease in 49 (61.3%) patients and disease progression was noted in 14 (17.4%) patients. Post-IC, resectability was achieved in 19 (23.8%) of 80 patients, but 4 of them did not undergo surgery due to logistic and personal reasons. The median OS of patients who underwent surgery followed by adjuvant local therapy (n = 15) was 16.9 months (95% CI: 15.2-19.8 months) and for those treated with nonsurgical local therapy (n = 65) was 8.8 months (95% CI: 6.8-10.6 months) (log-rank P = 0.000).

Conclusions: IC had a manageable toxicity profile and achieved resectability in 23.8% of our patients with technically unresectable T4a OSCC. Patients underwent resection had a significantly better median OS than those who received nonsurgical local treatment.

Keywords: Induction chemotherapy; oral cavity squamous cell cancers; technically unresectable.

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Conflict of interest statement

There are no conflicts of interest.

Figures

Figure 1
Figure 1
Kaplan–Meier curve of overall survival (in months) of patients with technically unresectable T4a oral cavity squamous cell cancers. The median overall survival of patients who underwent surgery followed by adjuvant local therapy (n = 15) was 16.9 months and for those treated with nonsurgical local therapy (n = 65) was 8.8 months (log-rank P = 0.000)
Figure 2
Figure 2
Kaplan–Meier curve of overall survival (in months) of patients with technically unresectable T4a oral cavity squamous cell cancers, who received nonsurgical local treatment postinduction chemotherapy (n = 65). The median overall survival for patients receiving definitive chemo-radiation, definitive radiation, palliative radiation, and best supportive care were 11.8, 8.5, 6.8, and 5.3 months, respectively
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