Effect of induction chemotherapy on survival in locally advanced head and neck squamous cell carcinoma treated with concurrent chemoradiotherapy: Single center experience

Head Neck. 2016 Feb;38(2):277-84. doi: 10.1002/hed.23891. Epub 2015 Jun 18.

Abstract

Background: Although induction chemotherapy can reduce distant metastases in locally advanced head and neck squamous cell carcinoma (HNSCC), overall survival (OS) improvement because of induction chemotherapy has not been confirmed.

Methods: We reviewed medical records of 224 patients diagnosed with locally advanced HNSCC who were treated with induction chemotherapy followed by concurrent chemoradiotherapy (CRT; induction chemotherapy/CRT; N = 144) and CRT alone (N = 80) from 2005 to 2013. We analyzed OS and progression-free survival (PFS).

Results: The 3-year OS rate was significantly higher in the induction chemotherapy/CRT group compared to the CRT group (74.0% vs 62.7%; p = .045). The 3-year PFS rate was 64.6% in the induction chemotherapy/CRT group and 54.1% in the CRT group (p = .060). Subgroup analysis showed patients with high N classification (N2 or N3) oropharyngeal cancer had greater benefits when treated with induction chemotherapy/CRT.

Conclusion: Induction chemotherapy plus CRT improved OS, compared to CRT alone in locally advanced HNSCC, especially with high N classification.

Keywords: concurrent chemoradiotherapy; head and neck cancer; induction chemotherapy; subgroup analysis; survival.

Publication types

  • Comparative Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Carcinoma, Squamous Cell / mortality*
  • Carcinoma, Squamous Cell / therapy*
  • Chemoradiotherapy*
  • Disease Progression
  • Female
  • Head and Neck Neoplasms / mortality*
  • Head and Neck Neoplasms / therapy*
  • Humans
  • Induction Chemotherapy*
  • Male
  • Middle Aged
  • Propensity Score
  • Retrospective Studies
  • Young Adult