title: Induction chemotherapy in technically unresectable locally advanced oral cavity cancers: does it make a difference?
abstract: BACKGROUND
  Locally advanced and unresectable oral cavity cancers have a poor prognosis. Induction might be beneficial in this setting by reducing tumor bulk and allowing definitive surgery.
  
  
  OBJECTIVE
  To analyze the impact of induction chemotherapy on locally advanced, technically unresectable oral cavity cancers.
  
  
  METHODS
  Retrospective analysis of patients with locally advanced oral cavity cancers, who were treated with neoadjuvant chemotherapy (NACT) during the period between June 2009 and December 2010. Data from a prospectively filled database were analyzed for information on patient characteristics, chemotherapy received, toxicity, response rates, local treatment offered, patterns of failure, and overall survival. The statistical analysis was performed with SPSS version 16.
  
  
  RESULTS
  123 patients, with a median age of 42 years were analyzed. Buccal mucosa was the most common subsite (68.30%). Three drug regimen was utilized in 26 patients (21.10%) and the rest received two drug regimen. Resectability was achieved in 17 patients treated with 3 drug regimen (68.00%) and 36 patients receiving 2 drug regimen. Febrile neutropenia was seen in 3 patients (3.09%) receiving 2 drug regimen and in 9 patients (34.62%) receiving 3 drug regimen. The estimated median OS was not reached in patients who had clinical response and underwent surgery as opposed to 8 months in patients treated with non-surgical modality post NACT (P = 0.0001).
  
  
  CONCLUSIONS
  Induction chemotherapy was effective in converting technically unresectable oral cavity cancers to operable disease in approximately 40% of patients and was associated with significantly improved overall survival in comparison to nonsurgical treatment.
authors.affiliation: Department of Medical Oncology, Tata Memorial Hospital, Mumbai, Maharashtra, India.
authors.forename: V M
authors.initials: VM
authors.lastname: Patil
authors.forename: V
authors.initials: V
authors.lastname: Noronha
authors.forename: Amit
authors.initials: A
authors.lastname: Joshi
authors.forename: V K
authors.initials: VK
authors.lastname: Muddu
authors.forename: S
authors.initials: S
authors.lastname: Gulia
authors.forename: B
authors.initials: B
authors.lastname: Bhosale
authors.forename: S
authors.initials: S
authors.lastname: Arya
authors.forename: S
authors.initials: S
authors.lastname: Juvekar
authors.forename: P
authors.initials: P
authors.lastname: Chatturvedi
authors.forename: D A
authors.initials: DA
authors.lastname: Chaukar
authors.forename: P
authors.initials: P
authors.lastname: Pai
authors.forename: A
authors.initials: A
authors.lastname: D'cruz
authors.forename: K
authors.initials: K
authors.lastname: Prabhash
mesh_terms: D000328:Adult; D000368:Aged; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D001952:Bridged-Ring Compounds / Q000008:administration & dosage / Q000009:adverse effects; D000077143:Docetaxel; D005260:Female; D005472:Fluorouracil / Q000008:administration & dosage / Q000009:adverse effects; D006801:Humans; D060828:Induction Chemotherapy; D008297:Male; D008875:Middle Aged; D009062:Mouth Neoplasms / Q000188:drug therapy* / Q000473:pathology / Q000601:surgery; D020360:Neoadjuvant Therapy; D009367:Neoplasm Staging; D009503:Neutropenia / Q000209:etiology; D010984:Platinum / Q000008:administration & dosage / Q000009:adverse effects; D012189:Retrospective Studies; D016019:Survival Analysis; D043823:Taxoids / Q000008:administration & dosage / Q000009:adverse effects; D055815:Young Adult
chemical_list: D001952:Bridged-Ring Compounds; D043823:Taxoids; D000077143:Docetaxel; C080625:taxane; D010984:Platinum; D005472:Fluorouracil