Response to induction chemotherapy as a prognostic indicator in locally advanced head and neck squamous cell carcinoma

J Cancer Res Clin Oncol. 2024 Dec 4;151(1):2. doi: 10.1007/s00432-024-06044-2.

Abstract

Purpose: Induction chemotherapy (IC) for patients with locally advanced stage Head and Neck Squamous Cell Carcinomas (HNSCC) before radio-chemotherapy (RCT) or surgery remains a potential treatment option. This study analyzed how the response to IC correlates with survival outcomes.

Methods: We conducted a retrospective single-center study at a tertiary cancer center. Tumors were categorized by anatomical site and response to IC (non-responders vs. responders). Data were analyzed using Kaplan-Meier survival curves and Cox regression analysis.

Results: A total of 48 patients received IC. Of these, 33 patients were radiologically evaluable for response. The majority of evaluable patients received either TPF (Docetaxel, Cisplatin, 5-Fluorouracil) (58%) or TP (Docetaxel, Cisplatin) (24%) as their IC regimen. Tumor reduction of 30% or more was observed in 23 patients (69.7%), the tumor control rate was 97%. The 2-year event-free survival (EFS) in the IC evaluable population was 53.1%, overall survival (OS) was 63.6%, and recurrence-free survival (RFS) was 62.5%. Patients with laryngeal or hypopharyngeal tumors that did not respond to IC had a significantly poorer prognosis. This effect was not statistically significant in tumors of the oral cavity or oropharynx, where it was only observed as a trend.

Conclusion: IC is highly effective in treating locally advanced stage HNSCC. The response to IC is prognostic for survival, particularly in cancers of the larynx and hypopharynx.

Keywords: Chemotherapy response; Head and neck squamous cell carcinoma; Induction chemotherapy; Survival Prediction.

MeSH terms

  • Adult
  • Aged
  • Antineoplastic Combined Chemotherapy Protocols* / therapeutic use
  • Cisplatin* / administration & dosage
  • Cisplatin* / therapeutic use
  • Docetaxel* / administration & dosage
  • Docetaxel* / therapeutic use
  • Female
  • Fluorouracil / administration & dosage
  • Fluorouracil / therapeutic use
  • Head and Neck Neoplasms* / drug therapy
  • Head and Neck Neoplasms* / mortality
  • Head and Neck Neoplasms* / pathology
  • Head and Neck Neoplasms* / therapy
  • Humans
  • Induction Chemotherapy* / methods
  • Kaplan-Meier Estimate
  • Male
  • Middle Aged
  • Prognosis
  • Retrospective Studies
  • Squamous Cell Carcinoma of Head and Neck* / drug therapy
  • Squamous Cell Carcinoma of Head and Neck* / mortality
  • Squamous Cell Carcinoma of Head and Neck* / pathology
  • Squamous Cell Carcinoma of Head and Neck* / therapy

Substances

  • Docetaxel
  • Cisplatin
  • Fluorouracil