FEASIBILITY OF INDUCTION CHEMOTHERAPY IN THE TREATMENT OF CT2N0M0 CANCER OF THE ORAL MUCOSA

Abstract

Introduction. The issue of selecting treatment strategy for сT2N0M0 cancer of the oral mucosa remains relevant. Induction chemotherapy (applied in order to evaluate the possibility of organ-preserving chemoradiotherapy) is widely used in clinical practice. In this case, surgical treatment is performed only when chemotherapy (CT) is ineffective or a residual tumor is detected after chemoradiotherapy (CRT). However, many specialists recommend surgical treatment on the first stage of treatment.Objective: evaluation of the induction chemotherapy feasibility in the treatment of T2N0M0 cancer of the oral mucosa.Materials and methods. A total of 122 patients with primary Т2N0М0 cancer of oral mucosa without regional metastases (according to clinical examination) were included in the study.Results. In order to determine the best treatment strategy, we have compared treatment outcomes in three groups of patients. The most favorable outcomes were observed in the group of patients receiving combined treatment according to a scheme «surgery + radiotherapy (RT)/ CRT, where the overall 5-year survival rate and the progression-free 5-year survival rate were 70.4 % and 68.5 % respectively. Survival rate in this group was significantly higher (р < 0.05) than that in the group «induction CT (ICT) ± RT ± surgery» where these parameters comprised 42.2 % and 36.2 % respectively.Conclusion. Combined treatment with a surgery on the first stage followed by RT or CRT ensures better outcomes of the cancer of the oral mucosa than the strategies that include ICT.

Keywords

• head and neck cancer
• squamous cell carcinoma
• cancer of the oral mucosa
• induction chemotherapy
• combined treatment