1. Neoadjuvant radiochemotherapy and radical resection for advanced squamous cell carcinoma of the oral cavity. Outcome of 134 patients.
- Author
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Eich HT, Löschcke M, Scheer M, Kocher M, Bongartz R, Wacker S, Zöller JE, and Müller RP
- Subjects
- Adult, Aged, Carcinoma, Squamous Cell drug therapy, Carcinoma, Squamous Cell pathology, Carcinoma, Squamous Cell surgery, Combined Modality Therapy, Disease-Free Survival, Female, Follow-Up Studies, Humans, Kaplan-Meier Estimate, Lymphatic Metastasis pathology, Male, Middle Aged, Mouth Neoplasms drug therapy, Mouth Neoplasms pathology, Mouth Neoplasms surgery, Neoplasm Staging, Prognosis, Radiotherapy Dosage, Retrospective Studies, Antineoplastic Agents therapeutic use, Carboplatin therapeutic use, Carcinoma, Squamous Cell radiotherapy, Mouth Neoplasms radiotherapy, Neck Dissection, Neoadjuvant Therapy
- Abstract
Background and Purpose: Several multimodal strategies have been developed to treat patients with squamous cell carcinoma of the oral cavity. The advantages of preoperative radiochemotherapy are downstaging of the primary tumor, an increased resectability rate, and the elimination of micrometastases. After successful phase II trials, the following therapy regimen for resectable advanced oral carcinoma was applied., Patients and Methods: 134 patients with resectable squamous cell carcinoma of the oral cavity stage II-IV received neoadjuvant radiochemotherapy consisting of 39.6 Gy in daily fractions of 1.8 Gy and concomitant carboplatin (70 mg/m(2) days 1-5). Radical resection and neck dissection were carried out afterwards., Results: After a median follow-up of 73 months, 82 patients (61%) had died. 54 patients (40%) experienced locoregional relapses or distant metastases. The overall survival was 65% +/- 4% after 2 years and 45% +/- 4% after 5 years. Cox regression survival analysis identified tumor regression, extracapsular lymph node spread and resection state as prognostic factors. Side effects of grade 3-4 were rare., Conclusion: Neoadjuvant radiochemotherapy with subsequent radical surgery can be recommended as an effective and safe treatment for primary resectable advanced tumors of the oral cavity. Acute and long-term toxicities appear to be moderate.
- Published
- 2008
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