Abstract：
OBJECTIVES:Chemoradiation is the treatment of choice for carcinomas of the pharynx and larynx with imminent loss of organ or function. However, the prognosis after CRT decreases when salvage surgery becomes necessary. Single-cycle induction chemotherapy is therefore performed to identify patients who would benefit more from S than from CRT. The present study aims to evaluate the feasibility and effectiveness of this approach. MATERIALS AND METHODS:Forty-seven patients received Induction Chemotherapy (IC) with docetaxel plus cisplatin or carboplatin and were subsequently assessed for tumor response. Responders achieving a ≥30% decrease in endoscopic tumor size and a ≥20% decrease in 18F-fluorodeoxyglucose uptake proceeded to primary Chemoradiation (CRT) and non-responders received surgery (S). Six weeks after CRT patients with residual tumors underwent secondary surgery (S). RESULTS:Thirty eight patients were elected for CRT and 9 received S. A local control rate of 86.1% and disease-free survival of 80.4% was achieved at 2 years. Overall treatment time in CRT-patients >80 days was associated with inferior disease-free survival (p = 0.05), cause-specific survival (p = 0.02), overall survival (p = 0.01) and a trend to inferior local control (p = 0.07) at 2 years. CONCLUSION:The strategy of selecting patients for CRT vs. S based on the response to IC achieves encouraging rates of disease control by surgery and CRT.
journal_name
Oral Oncoljournal_title
Oral oncologyauthors
Semrau S,Schmidt D,Lell M,Waldfahrer F,Lettmaier S,Kuwert T,Iro H,Fietkau Rdoi
10.1016/j.oraloncology.2012.12.008subject
Has Abstractpub_date
2013-05-01 00:00:00pages
454-60issue
5eissn
1368-8375issn
1879-0593pii
S1368-8375(12)00394-6journal_volume
49pub_type
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