title: [The role of chemotherapy in advanced oral cavity cancer].
abstract: OBJECTIVE
  To evaluate the role of chemotherapy in advanced cancer of the oral cavity by assessing its influence on the survival of patients receiving palliative care and its ability to improve the expectations of curative surgery.
  
  
  METHODS
  Ninety-nine consecutive patients were analyzed to assess their course, the prognostic factors for tumour progression, and overall survival after treatment with two different chemotherapy regimes: cisplatin plus bleomycin (n=45) or cisplatin plus 5-fluorouracil (n=52). For the analysis, patients were split into groups depending on the treatment intention: palliative (n=41) or neo-adjuvant (n=56).
  
  
  RESULTS
  The response rate was 56.7%. The response was greater in the neo-adjuvant group (73.2%) than among the palliative patients (36.6%) (P<0.001); greater with the bleomycin regime (73.3%) than with 5-fluorouracil (44.2%) (P=0.003); and greater in patients with stage III (77.8%) than stage IV (50%) (P=0.021). Survival was higher among patients receiving bleomycin than in those on 5-fluorouracil (P=0.019) and among those with stage III than stage IV (P=0.013). In the palliative treatment group, the response was associated with greater survival (P<0.001). In the neo-adjuvant group, 30 patients (53.6%) underwent surgery, with complete resection in 26 of them (86.7%). Sixteen cases (61.5%) presented recurrence. Chemotherapy response was not associated with operability. Survival was higher in the group with complete tumour resection (P<0.041).
  
  
  CONCLUSIONS
  The response to chemotherapy in oral cavity tumours was greater in patients with stage III and in those receiving bleomycin. Chemotherapy may improve survival in palliative cases. In neo-adjuvant cases, no great influence was seen in the conversion of doubtful cases into candidates for surgery.
authors.affiliation: Servicio de Otorrinolaringología, Hospital Clínic de Barcelona, Barcelona, España. mcaba@clinic.ub.es
authors.forename: Miguel
authors.initials: M
authors.lastname: Caballero
authors.forename: Juan J
authors.initials: JJ
authors.lastname: Grau
authors.forename: Sandra
authors.initials: S
authors.lastname: Casellas
authors.forename: Manuel
authors.initials: M
authors.lastname: Bernal-Sprekelsen
authors.forename: José L
authors.initials: JL
authors.lastname: Blanch
mesh_terms: D000970:Antineoplastic Agents / Q000627:therapeutic use*; D001761:Bleomycin / Q000627:therapeutic use*; D002945:Cisplatin / Q000627:therapeutic use*; D005260:Female; D005472:Fluorouracil / Q000627:therapeutic use*; D006801:Humans; D008297:Male; D009062:Mouth Neoplasms / Q000188:drug therapy* / Q000473:pathology; D009367:Neoplasm Staging
chemical_list: D000970:Antineoplastic Agents; D001761:Bleomycin; D002945:Cisplatin; D005472:Fluorouracil