Neoadjuvant chemotherapy: role in locoregionally advanced oral cancers
Journal Title: International Journal of Medical Science and Public Health - Year 2015, Vol 4, Issue 6
Abstract
Background: Oral cancers are the most predominant cancers in our region due to the habit of betel nut chewing. The treatment protocols available have not given satisfactory results. Neoadjuvant chemotherapy has been tried out successfully in other cancers like cancer of larynx. Objectives : Our study aimed to assess the response of neoadjuvant chemotherapy in locally advanced oral cancer. Materials and Methods : A total of 40 patients were taken up for the study; 20 patients each in both study and the control groups. In the study group, patients were subjected to three cycles of neoadjuvant chemotherapy (cisplatin and 5- fluorouracil) after doing relevant investigations, later evaluated for resectability, and later taken up for surgery or radiotherapy depending on the response. In the control arm, all the patients were directly taken up for surgery. Results: The results showed that among the 20 patients who underwent neoadjuvant chemotherapy no one had complete response, 55% had partial response, 35% had stable disease, and 2 had progressive disease and were advised palliative radiotherapy only. Two patients in study arm were lost for follow-up. The remaining 16 patients in study arm and all 20 patients in control arm were taken up for surgery. The specimens were assessed histopathologically for positive margins. Almost equal incidence of positive margins was found in both arms. The patients were followed up for 2 years after surgery. The results showed marginally better disease-free survival in stage III disease patients who underwent neoadjuvant chemotherapy followed by surgery compared to those who had direct surgery; however, no major difference in patient with stage IVA disease was seen. Conclusion: Neoadjuvant chemotherapy in locally advanced oral cancers delays the progression of disease and gives partial response macroscopically. There was no significant improvement in locoregional control, disease-free survival, and overall survival of the patients.
Authors and Affiliations
Manpreet Singh Nanda, Azeem Mohiyuddin
Keywords
Related Articles
- EP ID EP148527
- DOI 10.5455/ijmsph.2015.20022015146
- Views 91
- Downloads 0
Lung function abnormalities in flour mill workers using spirometry
Background: Few studies have been carried out to analyze the impact of flour dust on the lung function of flour mill workers. Objective: To assess the lung function of flour mill workers and to study the lung fun...
Measuring patient satisfaction: a need of the day for tertiary care services
Background: Patient satisfaction is an important measure as it is a primary means of measuring the effectiveness of health-care delivery and success of health-care facility. Objective: To evaluate the satisfaction...
Histopathological alterations in lung tissue received as autopsy specimens- a study of 410 cases
Background: Many millions of people around the world suffer from preventable pulmonary diseases. The clinical and radiological findings in most of the respiratory diseases are nonspecific and correct diagnosis cannot be...
Awareness regarding tuberculosis among adolescents of urban slums
Background: Tuberculosis (TB) has become a major public health problem affecting young adults leading to morbidity and mortality, despite TB control program being there for more than 30 years. Aims &am...
Comparative evaluation of surgical modalities in cases with obstructive sleep apnea syndrome
Background: Sleep apnea is divided into three main types: central sleep apnea syndrome (CSAS), obstructive sleep apnea syndrome (OSAS), and mixed sleep apnea syndrome (MSAS). OSAS is responsible for 80% of cases o...