| ORIGINAL ARTICLE |
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| Year : 2020 | Volume
: 4
| Issue : 3 | Page : 105-109 |
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Induction chemotherapy in locally advanced head-and-neck squamous cell carcinoma: Real-world outcome
Vijay Gnanaguru1, Manikandan Dhanushkodi1, Venkatraman Radhakrishnan1, Jayachandran Perumal Kalaiarasi1, Arun Kumar Rajan1, Gangothri Selvarajan1, Sivasree Kesana1, Srikamakshi Kothandaraman2, Shobana Sekhar2, Venktesh Vaidhyalingam2, Arvind Krishnamurthi2, Aswin Nagarajan3, Kuluvoya Ramanaiah3, Harish Kumar3, Arun Kumar3, Ram Madhavan3, Alexander John3, Rama Ranganathan4, Trivadi Sundaram Ganesan1, Tenali Gnana Sagar1
1 Department of Medical Oncology, Cancer Institute (WIA), Chennai, Tamil Nadu, India
2 Department of Surgical Oncology, Cancer Institute (WIA), Chennai, Tamil Nadu, India
3 Department of Radiation Oncology, Cancer Institute (WIA), Chennai, Tamil Nadu, India
4 Department of Epidemiology Biostatistics and Tumor Registry, Cancer Institute (WIA), Chennai, Tamil Nadu, India
Correspondence Address:
Manikandan Dhanushkodi
Department of Medical Oncology, Cancer Institute (WIA), 38, Sardar Patel Road, Chennai - 600 036, Tamil Nadu
India
 Source of Support: None, Conflict of Interest: None
DOI: 10.4103/oji.oji_21_20
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Introduction: Patients with locally advanced head-and-neck squamous cell carcinoma (LAHNSCC) have a poor prognosis despite multimodality treatment. Aim: This study was done to assess the efficacy and toxicity of induction chemotherapy (IC) in patients with LAHNSCC. Materials and Methods: This was a retrospective study of patients with LAHNSCC who were treated with IC from May 2016 to July 2019 from a tertiary care cancer center in India. Results: A total of 26 patients were included in this analysis, with a median follow-up of 9.5 months. The majority of the patients had carcinoma of the oral cavity (96.2%, n = 25) and 1 (3.8%) had oropharyngeal cancer. The most common oral cavity subsites were buccal mucosa (65.4%) and gingivum (11.5%). Fifteen patients received a triplet regimen of IC and 11 patients received a doublet IC regimen. Among patients with an evaluable disease for response assessment (n = 21), complete response, partial response, stable disease, and progressive disease were seen in 9.5%, 66.7%, 19%, and 4.8%, respectively. Among patients with unresectable (Stage IVB) Oral squamous cell cancer (OSCCs), 40% underwent surgery. The median progression-free survival (PFS) was 8 months. Patients who underwent surgery after IC had a better PFS as compared to those who underwent nonoperative local therapy (12 months vs. 8 months). IC-induced Grade 3 or more toxicity occurred in 45% of the patients and mortality occurred in 2 patients (7.7%) due to neutropenic sepsis. Conclusion: IC is feasible in patients with inoperable LAHNSCC. Patients who underwent surgery after IC had a trend towards better PFS as compared to those who underwent nonsurgical local therapy after IC.
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