[Introductory chemotherapy in epidermoid carcinoma of the head and neck. Apropos of a retrospective study of 293 patients].
The authors present a retrospective study of 293 patients treated by neoadjuvant chemotherapy for squamous cell carcinoma of the head and neck without metastases. The results are globally analyzed for all localizations, as well as separately for each localization (larynx, hypopharynx, oropharynx). The aims of this study are to evaluate the results of neoadjuvant chemotherapy in the different tumor sites of the upper aerodigestive tract, to identify the predictive factors of a complete response, and to ascertain if neoadjuvant chemotherapy allows to alleviate the locoregional treatment without compromising survival. In laryngeal cancers, the organ conservation rate was 20.8%. If chemotherapy does not improve survival in patients with laryngeal cancer, it should be noted that survival of patients who had a total response of their tumor to chemotherapy is better than that of non-responders. In hypopharyngeal cancers, the organ conservation rate was 30% and no statistically significant difference in survival was noted as a function of the different parameters studied. As for oropharyngeal cancers, chemotherapy obtained, in our series, a total clinical response, and thus avoiding oropharyngeal surgery, in 46.2% of cases. In this localization, the survival of totally-responding patients is greater in a statistically significant manner at 5 years than in non-responding patients. Globally, chemotherapy does not improve survival, but does allow for a gain in the quality of survival, permitting a non-negligible rate of organ preservation as a function of tumor site. The tumor stage, the lymph node status, as well as the initial performance index represent predictive factors of total response to neoadjuvant chemotherapy. Analysis of our results had led us to reserve neoadjuvant chemotherapy in T3 laryngeal and hypopharyngeal cancers, in T3 cancers of the tonsil and the tonsiloglossal fold, as well as T2-T3 tumors of base of the tongue and soft palate.
Percodani
J
J
Service d'O.R.L. et de Chirurgie Cervico-Faciale, C.H.U. de Rangueil, Toulouse, France.
Woisard
V
V
Serrano
E
E
Pessey
J J
JJ
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002294:Carcinoma, Squamous Cell / Q000188:drug therapy*; D017024:Chemotherapy, Adjuvant; D005260:Female; D006258:Head and Neck Neoplasms / Q000188:drug therapy* / Q000473:pathology; D006801:Humans; D008207:Lymphatic Metastasis; D008297:Male; D008875:Middle Aged; D009362:Neoplasm Metastasis; D009364:Neoplasm Recurrence, Local; D009367:Neoplasm Staging; D012189:Retrospective Studies
La chimiothérapie d'induction dans les carcinomes épidermoïdes des VADS. A propos d'une étude rétrospective sur 293 patients.