Single-cycle induction chemotherapy before chemoradiotherapy or surgery in functionally inoperable head and neck squamous cell carcinoma : 10-year results
INTRODUCTION: The response to induction chemotherapy (IC) predicts local control after conservative treatment of laryngeal, meso- and hypopharyngeal head and neck squamous cell carcinoma (HNSCC) and can thus help to avoid surgery. Single-cycle induction chemotherapy may help to maintain a low local recurrence rate while keeping the overall toxicity manageable. However, long-term data on single-cycle IC response by tumor location is lacking.
METHODS: N = 102 patients with functionally inoperable primary HNSCC of the larynx (n = 43), hypopharynx (n = 42) or mesopharynx/tongue (n = 17) received one cycle of docetaxel (75 mg/m2, d1) plus cisplatin (30 mg/m2, d1-3) or carboplatin (AUC 1.5, d1-3) and a response evaluation 3 weeks later. Responders (≥ 30% tumor size reduction and ≥ 20% SUVmax decrease in 18F-FDG PET/CT) were recommended chemoradiotherapy (CRT), and non-responders surgery.
RESULTS: The overall response rate was 72.5%. All 74 responders and 10 non-responders received primary CRT, and 18 patients received primary surgery after single-cycle IC. Overall 10-year local recurrence-free survival (LRFS) was 73.7%. Three-year LRFS was 88.2% (mesopharynx/tongue), 88.2% (larynx), and 73.3% (hypopharynx); p = 0.17. 3-year distant metastasis-free survival (DMFS) was 94.1% (mesopharynx/tongue), 88.0% (larynx) and 76.4% (hypopharynx); p > 0.05. This influenced the 3-year cancer-specific survival (CSS) for larynx (91.2%) vs. hypopharynx tumors (60.8%); p = 0.003, but CSS was not different to tumors in the mesopharynx/tongue (81.4%); p > 0.05.
CONCLUSIONS: A single-cycle induction chemotherapy for HNSCC enables surgery plus adjuvant therapy as well as chemoradiotherapy. The long-term local and distant disease control was good but varied between tumors in the larynx and mesopharynx/tongue vs. hypopharynx.
| Medienart: |
E-Artikel |
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| Erscheinungsjahr: |
2020 |
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| Erschienen: |
2020 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:277 |
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| Enthalten in: |
European archives of oto-rhino-laryngology : official journal of the European Federation of Oto-Rhino-Laryngological Societies (EUFOS) : affiliated with the German Society for Oto-Rhino-Laryngology - Head and Neck Surgery - 277(2020), 1 vom: 16. Jan., Seite 245-254 |
| Sprache: |
Englisch |
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| Beteiligte Personen: |
Breheret, Marius [VerfasserIn] |
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| Links: |
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| Themen: |
Head and neck squamous cell carcinoma (HNSCC) |
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| Anmerkungen: |
Date Completed 16.11.2020 Date Revised 16.01.2021 published: Print-Electronic Citation Status MEDLINE |
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| doi: |
10.1007/s00405-019-05665-5 |
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| funding: |
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| Förderinstitution / Projekttitel: |
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| PPN (Katalog-ID): |
NLM301906521 |
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| 100 | 1 | |a Breheret, Marius |e verfasserin |4 aut | |
| 245 | 1 | 0 | |a Single-cycle induction chemotherapy before chemoradiotherapy or surgery in functionally inoperable head and neck squamous cell carcinoma |b 10-year results |
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| 500 | |a Citation Status MEDLINE | ||
| 520 | |a INTRODUCTION: The response to induction chemotherapy (IC) predicts local control after conservative treatment of laryngeal, meso- and hypopharyngeal head and neck squamous cell carcinoma (HNSCC) and can thus help to avoid surgery. Single-cycle induction chemotherapy may help to maintain a low local recurrence rate while keeping the overall toxicity manageable. However, long-term data on single-cycle IC response by tumor location is lacking | ||
| 520 | |a METHODS: N = 102 patients with functionally inoperable primary HNSCC of the larynx (n = 43), hypopharynx (n = 42) or mesopharynx/tongue (n = 17) received one cycle of docetaxel (75 mg/m2, d1) plus cisplatin (30 mg/m2, d1-3) or carboplatin (AUC 1.5, d1-3) and a response evaluation 3 weeks later. Responders (≥ 30% tumor size reduction and ≥ 20% SUVmax decrease in 18F-FDG PET/CT) were recommended chemoradiotherapy (CRT), and non-responders surgery | ||
| 520 | |a RESULTS: The overall response rate was 72.5%. All 74 responders and 10 non-responders received primary CRT, and 18 patients received primary surgery after single-cycle IC. Overall 10-year local recurrence-free survival (LRFS) was 73.7%. Three-year LRFS was 88.2% (mesopharynx/tongue), 88.2% (larynx), and 73.3% (hypopharynx); p = 0.17. 3-year distant metastasis-free survival (DMFS) was 94.1% (mesopharynx/tongue), 88.0% (larynx) and 76.4% (hypopharynx); p > 0.05. This influenced the 3-year cancer-specific survival (CSS) for larynx (91.2%) vs. hypopharynx tumors (60.8%); p = 0.003, but CSS was not different to tumors in the mesopharynx/tongue (81.4%); p > 0.05 | ||
| 520 | |a CONCLUSIONS: A single-cycle induction chemotherapy for HNSCC enables surgery plus adjuvant therapy as well as chemoradiotherapy. The long-term local and distant disease control was good but varied between tumors in the larynx and mesopharynx/tongue vs. hypopharynx | ||
| 650 | 4 | |a Journal Article | |
| 650 | 4 | |a Head and neck squamous cell carcinoma (HNSCC) | |
| 650 | 4 | |a Induction chemotherapy | |
| 650 | 4 | |a Resection | |
| 650 | 4 | |a Single-cycle | |
| 700 | 1 | |a Lubgan, Dorota |e verfasserin |4 aut | |
| 700 | 1 | |a Haderlein, Marlen |e verfasserin |4 aut | |
| 700 | 1 | |a Hecht, Markus |e verfasserin |4 aut | |
| 700 | 1 | |a Traxdorf, Maximilian |e verfasserin |4 aut | |
| 700 | 1 | |a Schmidt, Daniela |e verfasserin |4 aut | |
| 700 | 1 | |a Müller, Sarina |e verfasserin |4 aut | |
| 700 | 1 | |a Kitzsteiner, Christian |e verfasserin |4 aut | |
| 700 | 1 | |a Kuwert, Torsten |e verfasserin |4 aut | |
| 700 | 1 | |a Iro, Heinrich |e verfasserin |4 aut | |
| 700 | 1 | |a Fietkau, Rainer |e verfasserin |4 aut | |
| 700 | 1 | |a Semrau, Sabine |e verfasserin |4 aut | |
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