In order to determine the efficiency of induction chemotherapy(CT) for unresectable or inoperable, locally advanced head and neck cancer, the authors conducted a retrospective study. Fifty-four patients were treated with CT and
radiotherapy(RT) (CT-RT group). This group wad compared with a group of 42 patients treated with RT alone(RT alone group). The CT regimens used were CVB(Cyclophosphamide. Vincristine and Bleomycin). CF(Cis-platinum and
5-fluorouracil),
CAP(Cyclophosphamide. Adriamycin and Prednisolone) or PVBV(Cis-platinum, Vincristin, Bleomycin and Methotrexate). Toxicity from induction chemotherapy was minimal, and toxicity was linited primarily to nausea and vomiting,
mucositis,
alopecia and myelosuppression. The complete response rate(CR) to CT was 14.8% and the partial response(PR) rate was 48.2% for an overall major response rate of 63%. The major response rate at the completion of locoregional therapy was
88.9%(48/54) with 32CR(59.3%)and 16PR(29.6%) for CT-Rt group and 80.9%(34/42) with 19CR(45.2%) and 15PR(35.7%) for RT alone group(p=0.3387). Median survival was 36 months for CT-RT group and 63 months for RT alone group. The overall
survival
rate at 2 year, 3 year, 5 year, respectively was 59.9%, 47.8%, and 41.2% for CT-RT group, and 51.5%, 51.5% and 51.5% for RT alone group(p=0.3838). Comparison between patients in both groups, stratified by overall stage, T and N stage,
site
and
pathology, all failed to show any significant difference in survival rate We conclude the this retrospective study failed to demonstrate and advantage for induction chemotherapy in unresectable or inoperable locally advanced head and
neck
cancers.
|