Retrospective analysis of surgical resection after induction chemotherapy for patients with T4b squamous cell head and neck cancer

Figures & data

Figure 1.  Treatment of T4b SCHNC patients.

Table I.  Patient characteristics (T4b, any N, M0) and induction chemotherapy.

No of paients	113
Median age	56 y
Sex
– Men	109 (96%)
– Women	4 (4%)
Tobacco
– No	4 (4%)
– Ex-Smoker (>10y)	7 (6%)
– Active Smoker	102 (90%)
PS (ECOG)
0	9 (8%)
1	97 (86%)
2	7 (6%)
Location
– Oral cavity	29 (26%)
– Oropharynx	34 (30%)
– Larynx	25 (22%)
– Hypopharynx	25 (22%)
Induction chemotherapy (IC)
UFTVP:UFT + Vinorelbine + Cisplatin	55 (49%)
PF: Cisplatin + 5FU	48 (42%)
CI: Carboplatin + Ifosfamide	10 (98%)
Response to IC (Primary Tumor)
– CR	35 (31%)
– PR > 90%	22 (19%)
– PR	34 (30%)
– EE	14 (12%)
– PD	4 (4%)
– Toxic deaths	4 (4%)

Table II.  Patient characteristics, treatment and outcome of patients resected after induction chemotherapy (IC).

Resection after IC	Age (Years)	Location	N	IC	Response (1°) after IC	Outcome (months after Resection) Relapse Survival*
R 1	45	Hipophar.	N2b	UFTVP	<90% PR	LR (4m)	Dead (8m)
	74	Supraglot.	N3	UFTVP	<90% PR	LR (4m)	Dead (17m)
	55	Oral Cav.	N0	PF	<90%PR	LR (3m)	Dead (6m)
	46	Orophar.	N2a	UFTVP	Minor R	LR + Syst. (8m)	Dead (19m)
	55	Hipophar.	N1	UFTVP	<90% PR	LR (16m)	Dead (44m)
	56	Oral Cav.	N0	CI	<90% PR	LR (37m)	Dead (43m)
	37	Oral Cav.	N3	PF	<90% PR	LR + Syst. (2m)	Dead (18m)
R 0	44	Hipophar.	N1	CI	Minor R	LR + Syst. (5m)	Dead (9m)
	43	Oral Cav.	N3	PF	<90% PR	LR (3m)	Dead (9m)
	60	Orophar.	N2a	PF	<90% PR	LR (5m)	Dead (9m)
	63	Supraglot.	N2a	UFTVP	<90% PR	No (+72m)	Alive (+72m)
	47	Supraglot.	N2a	PF	Minor R	No (+62m)	Alive (+62m)
	46	Glottis	N0	UFTVP	Minor R	No (+55m)	Alive (+55m)

UFTVP: UFT + Vinorelbine + Cisplatin; PF: Cisplatin + 5FU; CI: Carboplatin + Ifosfamide.

<90% PR: >50% and <90% Partial Response; Minor R: <50% Response.

LR: Locoregional relapse (only); LR + Syst.: Locoregional plus systemic relapse.

*All deaths were due to Progressive disease.

Figure 2.  Overall Survival of T4b patients who achieved less than a 90% response at primary according to primary resection after induction chemotherapy.

Figure 3.  Locoregional Control (LRC) of T4b patients who achieved less than a 90% response at primary according to primary resection after induction chemotherapy.