• 5/15/2005
  • Rome, Italy
  • Enzo Maria Ruggeri et al.
  • Head Neck, May 2, 2005

Background:
Neoadjuvant chemotherapy has been reported to be extremely active in head and neck cancer but has failed to give a statistically significant improvement in survival.

Methods:
From 1981 to 1994, 33 operable patients with locally advanced oral cavity cancer received cisplatin-based chemotherapy before surgery. Postoperative radiotherapy was performed in high-risk patients.

Results:
The overall clinical and pathologic complete response rates to neoadjuvant chemotherapy were 48% and 30%, respectively. At a median follow-up of 7.0 years (range, 0.3-15.3+ years), the 5-year and 10-year overall survival rates were 54.5% and 39.5%, and the disease-specific median survival was 6.6 years for all patients (8.3 and 2.3 years for stages III and IV, respectively). The univariate analysis showed a positive relationship between survival and male sex (p = .05), pathologic (p = .02), and clinical (p = .03) complete response. The Cox proportional hazard regression model confirmed the independent prognostic value of the clinical response with a 4.67 (95% CI, 1.70-12.86) hazard ratio. A second primary tumor occurred in six patients (18%), with a median of occurrence of 9 years (range, 7-11 years).

Conclusions:
This study confirms the prolonged survival expectancy largely exceeding 5 years for selected patients with stage IV and for most with stage III locally advanced oral cavity cancer achieving a clinical and/or pathologic complete response to chemotherapy.

Authors:
Enzo Maria Ruggeri, Paolo Carlini, Camillo Francesco Pollera, Salvatore De Marco, Paolo Ruscito, Paola Pinnaro, Mario Nardi, Diana Giannarelli, and Francesco Cognetti

Authors Affiliation:
Department of Medical Oncology, Regina Elena Cancer Institute, Istituto Regina Elena, Via Elio Chianesi, 53, 00144, Roma, Italy