title: Prognostic evaluation of preoperative thermochemoradiotherapy for N(3) cervical lymph node metastases of oral cancer.
abstract: OBJECTIVE
  The purpose of this study was to evaluate the clinical efficacy, histopathological efficacy, and response to preoperative thermochemoradiotherapy for N(3) cervical lymph node metastases of oral cancer.
  
  
  METHODS
  Preoperative thermochemoradiotherapy was performed in 8 patients with oral cancer and N(3) cervical lymph node metastasis. These patients underwent four-weekly sessions of hyperthermia, combined with radiotherapy (40 Gy) as well as chemotherapy with cisplatin (CDDP; 100 mg/m2), all prior to surgery. Radical neck dissection was performed 4 weeks after completion of preoperative thermochemoradiotherapy.
  
  
  RESULTS
  The preoperative treatment of cervical lymph node metastases yielded a partial response in 6 patients, while 2 patients demonstrated no change. Histopathologically, grade III was detected in 1, grade IIb in 4 and grade IIa in 3 patients after surgery, according to the criteria of Shimosato. The follow-up period ranged from 13 to 64 months (mean 34). Of the 8 patients, 2 died (1 of lymph node metastasis and 1 had metastasis to a distant site), and 6 patients were alive at the last follow-up, with the longest postoperative disease-free survival being 63 months. The 5-year cumulative survival rate was 70.0%.
  
  
  CONCLUSIONS
  These results indicate that preoperative thermochemoradiotherapy is a promising modality for patients with N(3) cervical lymph node metastasis of oral cancer.
authors.affiliation: Department of Maxillofacial Surgery, Nagoya University Graduate School of Medicine, Japan. tohnai@med.nagoya-u.ac.jp
authors.forename: Iwai
authors.initials: I
authors.lastname: Tohnai
authors.forename: Yasushi
authors.initials: Y
authors.lastname: Hayashi
authors.forename: Kenji
authors.initials: K
authors.lastname: Mitsudo
authors.forename: Toshio
authors.initials: T
authors.lastname: Shigetomi
authors.forename: Minoru
authors.initials: M
authors.lastname: Ueda
authors.forename: Takeo
authors.initials: T
authors.lastname: Ishigaki
mesh_terms: D000328:Adult; D000368:Aged; D000970:Antineoplastic Agents / Q000008:administration & dosage / Q000627:therapeutic use*; D002294:Carcinoma, Squamous Cell / Q000556:secondary / Q000628:therapy*; D002945:Cisplatin / Q000008:administration & dosage / Q000627:therapeutic use*; D003131:Combined Modality Therapy; D005260:Female; D006801:Humans; D006979:Hyperthermia, Induced; D008198:Lymph Nodes / Q000473:pathology; D008207:Lymphatic Metastasis; D008297:Male; D008875:Middle Aged; D009062:Mouth Neoplasms / Q000473:pathology / Q000628:therapy*; D009333:Neck; D037981:Neck Dissection; D009367:Neoplasm Staging; D011300:Preoperative Care; D011379:Prognosis; D011878:Radiotherapy; D015996:Survival Rate
chemical_list: D000970:Antineoplastic Agents; D002945:Cisplatin