title: Results and failures with or without cisplatin containing induction chemotherapy in the treatment of squamous cell carcinoma of the head and neck.
abstract: This prospective randomised study was undertaken to assess the effects and effectiveness of cisplatin in a pre-operative setting. Thirty-eight patients were treated with stage II-IVa (AJCC) squamous cell cancer of the oral cavity and oropharynx. Nineteen patients received a combination of bleomycin, vincristine, methotrexate (BVM; group I.), 19 received BVM and cisplatin (group II). Patients underwent surgery within 3 weeks after chemotherapy. Biopsy and surgical specimens were compared. A clinical complete response was seen in five patients in group I (26.3%) and in four patients in group II (21.1%). Partial response was noted in 11 patients in group I (57.8%) and in 13 patients in group II (68.4%). There was no statistical difference in clinical response between the two groups. Microscopic response was better in the cisplatin treated group. Median follow up of patients is 52 (36-70) months. Disease free survival showed a significant difference, favouring the no cisplatin group (P = 0.03). There was no significant difference in overall survival (P > 0.6). Cisplatin in combination with BVM showed significantly higher levels of microscopic response, but the lower disease free survival is mostly due to a higher rate of regional neck failure.
authors.affiliation: Department of Oral and Maxillofacial Surgery, Medical University Pécs, Dischka Gy. u 5., Pécs H-7621, Hungary. lajos.olasz@aok.pte.hu
authors.forename: Lajos
authors.initials: L
authors.lastname: Olasz
authors.forename: Arpád
authors.initials: A
authors.lastname: Németh
authors.forename: Zoltán
authors.initials: Z
authors.lastname: Nyárády
authors.forename: Tamás
authors.initials: T
authors.lastname: Tornóczky
authors.forename: László
authors.initials: L
authors.lastname: Királyfalvi
mesh_terms: D000328:Adult; D000368:Aged; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D001707:Biopsy, Needle; D002294:Carcinoma, Squamous Cell / Q000188:drug therapy* / Q000401:mortality / Q000473:pathology / Q000601:surgery*; D002945:Cisplatin / Q000008:administration & dosage*; D005500:Follow-Up Studies; D006258:Head and Neck Neoplasms / Q000188:drug therapy / Q000401:mortality / Q000473:pathology / Q000601:surgery*; D006801:Humans; D007150:Immunohistochemistry; D008875:Middle Aged; D009367:Neoplasm Staging; D011336:Probability; D011446:Prospective Studies; D012016:Reference Values; D012074:Remission Induction; D018570:Risk Assessment; D016019:Survival Analysis; D016896:Treatment Outcome
chemical_list: D002945:Cisplatin