Abstract
Background:
A total of 93 patients were treated with one of two preoperative chemotherapy regimens over a 15-year period. The study supports the importance of strict adherence to guidelines for ablative surgery.
Methods:
A single surgeon performed the surgery and evaluated each patient prior to treatment. The extent of the planned operation was documented.
Results:
The 5-year absolute survival of 88 patients who completed the protocol was estimated at 55%. The 40 cisplatin/5-fluorouracil-treated patients exhibited a significantly better outcome than the 48 cisplatin/bleomycin-treated patients (76% versus 43%, respectively). Comparison of a subset of 37 patients with a matched group from the standard control arm of the Head and Neck Contracts Program demonstrated a statistically significant improvement in overall survival over standard treatment.
Conclusions:
These data suggest that strict adherence to preoperative chemotherapy planning of ablative uncompromised surgery contribute to improved survival. Selective rather than routine postoperative radiotherapy may be advantageous.
Publication types
-
Clinical Trial
-
Comparative Study
MeSH terms
-
Antibiotics, Antineoplastic / administration & dosage
-
Antimetabolites, Antineoplastic / administration & dosage
-
Antineoplastic Agents / administration & dosage
-
Antineoplastic Combined Chemotherapy Protocols / administration & dosage
-
Antineoplastic Combined Chemotherapy Protocols / therapeutic use*
-
Bleomycin / administration & dosage
-
Carcinoma, Squamous Cell / drug therapy*
-
Carcinoma, Squamous Cell / radiotherapy
-
Carcinoma, Squamous Cell / surgery*
-
Case-Control Studies
-
Cisplatin / administration & dosage
-
Combined Modality Therapy
-
Fluorouracil / administration & dosage
-
Head and Neck Neoplasms / drug therapy*
-
Head and Neck Neoplasms / radiotherapy
-
Head and Neck Neoplasms / surgery*
-
Humans
-
Laryngeal Neoplasms / drug therapy
-
Laryngeal Neoplasms / radiotherapy
-
Laryngeal Neoplasms / surgery
-
Mouth Neoplasms / drug therapy
-
Mouth Neoplasms / radiotherapy
-
Mouth Neoplasms / surgery
-
Neck Dissection
-
Neoplasm Invasiveness
-
Neoplasm Staging
-
Oropharyngeal Neoplasms / drug therapy
-
Oropharyngeal Neoplasms / radiotherapy
-
Oropharyngeal Neoplasms / surgery
-
Postoperative Care
-
Preoperative Care
-
Proportional Hazards Models
-
Prospective Studies
-
Remission Induction
-
Survival Rate
-
Treatment Outcome
Substances
-
Antibiotics, Antineoplastic
-
Antimetabolites, Antineoplastic
-
Antineoplastic Agents
-
Bleomycin
-
Cisplatin
-
Fluorouracil