Article
The efficacy and valuation of induction chemotherapy in advanced head and neck carcinoma: first results after 6 years
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Published: | August 8, 2007 |
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Outline
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Induction: The custom surgical therapy of advanced head and neck carcinoma does often lead to a severe funktional deficit and visual disfiguration. Due to these facts we worked out a therapeutic concept which ought to combine an optimal longterm result with minimal mutilation.
Method: We selected 92 pts., 71 male, 21 female, with advanced untreated HNSCC. 9 patients stadium II, 9 patients stadium III, 74 patients stadium IV (UICC). Localisation: oropharynx 45 pts., hypopharynx 21 pts., larynx 8 pts., oral cavity 7 pts., CUP 4 pts., sinuses 3 pts., epipharynx 2 pts., outer ear canal 1 pt., trachea 1 pt. We applied an induction chemotherapy with 4 cycles of cisplatin (100mg) and 5-FU (1000mg). In case of response, complete response or partial response, a residual tumor was removed, if feasible under organ preservation with neck dissection, followed by radiation. In case of stable disease or progressive disease a chemoradiation was directly initiated after 2 cycles.
Results: 41% ( 38 pts.) showed a complete response, 38% (35 pts.) a partial response, 6% (5 pts.) a stable disease, 15% (14 pts.) a progressive disease. The median follow up was 20 months, in most cases an organ preservation could be achieved. There was a strong correlation between the response rate to the induction therapy and survival of the patients.
Conclusion: The efficacy, feasibility and reliability of the induction therapy is being confirmed with these results.