The Therapeutic Effect of Neoadjuvant Chemotherapy in Locally Advanced Oral Cavity Cancer

Korean Journal of Head & Neck Oncology 2001;17(2):179-184.
Published online November 30, 2001.

Yo Han Joh;In Sil Choi;Keun Wook Lee;Do Youn Oh;Byung Su Kim;Dae Ho Lee;Tae You Kim;Yung Jue Bang;Hong Gyun Wu;Myung Whun Sung;Chul Hee Lee;Noe Kyeong Kim;Dae Seog Heo

국소 진행성 구강암에서 선행 항암 화학 요법의 효과

조요한;최인실;이근욱;오도연;김병수;이대호;김태유;방영주;우홍균;성명훈;이철희;김광현;허대석

Abstract

Objective: The role of chemotherapy in locally advanced head and neck cancer has been established in nasopharynx and larynx as definitive therapy and organ preserving therapy, respectively. Oral cavity cancers are relatively uncommon and local recurrence is the main cause of treatment failure. We planned this retrospective study to evaluate the role of neoadjuvant chemotherapy in locally advanced oral cavity cancer patients. Materials and Methods: From 1988 March to 2001 February, locally advanced, previously untreated oral cavity cancer patients who received neoadjuvant chemotherapy were examined. Chemotherapy had been done in the following patients: Histologically proven squamous cell or poorly differentiated carcinoma, stage 3 or 4, and performance state 0-2 patients. Chemotherapy regimen consisted of cisplatin and infusional 5-fluorouracil. Response was evaluated after 2 cycles and in case of no response, definitive local therapy was done; otherwise 3 cycles was done before local treatment.
Results
48 patients were treated and 47 patients were evaluable for responses. Complete response rate was 6.4%(3/47) and partial response 80.0%(38/47), scoring overall response rate of 87.2%. Median time to progression was 27.0 months (95% CI : 0-58months) and overall 5 year survival was 54.8%. 5-year disease-free survival in the patients in remission after local treatment was 51.9%. In multivariate analysis, contributing factor to the survival were response to neoadjuvant chemotherapy and local treatment modalities. Extensive surgery was done in 10 patients and 25 patents (52.1%) was followed up with preserved function. With median follow-up of 57.0 months, 19 recurrences were detected, most of which were local or regional type.
Conclusion
Neoadjuvant chemotherapy followed by local treatment in oral cavity cancer showed high response rate and was thought to be effective therapeutic approach especially in view of organ preservation.

Key Words: Oral cavity, Neoadjuvant chemotherapy, Organ preservation