Outcome of patients following neo-adjuvant chemotherapy for unresectable cervical nodes in head and neck squamous cell carcinomas

Eur Arch Otorhinolaryngol. 2019 Feb;276(2):567-574. doi: 10.1007/s00405-018-5253-4. Epub 2018 Dec 17.

Abstract

Background: This study was undertaken to assess the effects of neo-adjuvant chemotherapy (NACT) on patients with head and neck squamous cell carcinoma (HNSCC) having advanced unresectable cervical nodal metastasis.

Methodology: A retrospective cohort study was conducted to assess the response of unresectable nodes to NACT in a pragmatic manner. Patients were grouped according to the response noted and the treatment offered after chemotherapy. The median survival amongst the patients in these groups was compared.

Results: The study included 51 patients. Oral cavity was the commonest site (67.2%). Favourable nodal response was seen in 64.7% of the patients. Up to 87.9% of the nodal responders were amenable to curative intent therapy. The overall survival of patients undergoing surgery, definitive chemoradiotherapy, palliative chemotherapy and palliative radiotherapy was 24, 13, 10 and 9 months, respectively.

Conclusion: NACT may be utilized in HNSCC with advanced inoperable nodal disease to make them amenable to definitive therapy.

Keywords: Head and neck cancers; Induction chemotherapy; Response; Unresectable nodes.

MeSH terms

  • Adult
  • Aged
  • Carcinoma, Squamous Cell / mortality*
  • Carcinoma, Squamous Cell / therapy*
  • Chemoradiotherapy
  • Chemotherapy, Adjuvant
  • Cohort Studies
  • Female
  • Head and Neck Neoplasms / mortality*
  • Head and Neck Neoplasms / therapy*
  • Humans
  • Lymph Nodes / drug effects
  • Lymphatic Metastasis*
  • Male
  • Middle Aged
  • Neoadjuvant Therapy*
  • Radiotherapy, Adjuvant
  • Retrospective Studies
  • Young Adult