The role of induction chemotherapy in patients with locally advanced head and neck squamous cell carcinoma: A nationwide population-based matched study

Meng-Che Hsieh; Chih-Chun Wang; Chuan-Chien Yang; Ching-Feng Lien; Chien-Chung Wang; Yu-Chen Shih; Shyh-An Yeh; Tzer-Zen Hwang

doi:10.1016/j.oraloncology.2022.105848

The role of induction chemotherapy in patients with locally advanced head and neck squamous cell carcinoma: A nationwide population-based matched study

Oral Oncol. 2022 May:128:105848. doi: 10.1016/j.oraloncology.2022.105848. Epub 2022 Mar 29.

Authors

Meng-Che Hsieh¹, Chih-Chun Wang², Chuan-Chien Yang², Ching-Feng Lien², Chien-Chung Wang², Yu-Chen Shih³, Shyh-An Yeh⁴, Tzer-Zen Hwang⁵

Affiliations

¹ Department of Hematology-Oncology, E-Da Cancer Hospital, Kaohsiung, Taiwan; College of Medicine, I-Shou University, Kaohsiung, Taiwan.
² College of Medicine, I-Shou University, Kaohsiung, Taiwan; Department of Otolaryngology, E-Da Hospital, Kaohsiung, Taiwan.
³ College of Medicine, I-Shou University, Kaohsiung, Taiwan; Department of Otolaryngology, E-Da Cancer Hospital, Kaohsiung, Taiwan.
⁴ College of Medicine, I-Shou University, Kaohsiung, Taiwan; Department of Radiation Oncology, E-Da Hospital, Kaohsiung, Taiwan.
⁵ College of Medicine, I-Shou University, Kaohsiung, Taiwan; Department of Otolaryngology, E-Da Hospital, Kaohsiung, Taiwan. Electronic address: ed111216@edah.org.tw.

PMID: 35364548
DOI: 10.1016/j.oraloncology.2022.105848

Abstract

Introduction: Induction chemotherapy (IC) has a proven role in organ preservation and reducing distant failure. However, its ability to prolong survival remains controversy. Herein, our study aimed to investigate the impact of primary tumor location on survival in patients with locally advanced head and neck squamous cell carcinoma (LA-HNSCC) treated with IC.

Methods: Patients who were older than 18 years and diagnosed with LA-HNSCC between 2007 and 2016 were retrospectively identified from Taiwan National Health Insurance Research Database and Taiwan Cancer Registry. Patients were categorized into two group: IC group and CCRT group. In order to reduce the selection bias, IC patients were individually matched with the CCRT patients. The oncologic outcomes were presented with overall survival (OS).

Results: A total of 5547 patients were identified. After matching, 2208 patients were analyzed for outcomes comparison, including 1104 patients in each group. In general, median OS were 27.3 months versus 28.5 months in IC and CCRT group, respectively (p = 0.6151). Patients were stratified by primary tumor location. For patients with oral cavity cancers, the median OS was significantly inferior in IC group than those in CCRT group, while for patients with non-oral cavity cancer, the median OS was superior in IC group than those in CCRT group.

Conclusions: Primary tumor location has a significant impact on survival in patients with LA-HNSCC treated with IC. Our study provides a strong evidence that primary tumor location should be taken into consideration during multidisciplinary approach.

Keywords: Concurrent chemoradiotherapy; Induction chemotherapy; Locally advanced head and neck squamous cell carcinoma; Primary tumor location; Survival.

Publication types

Research Support, Non-U.S. Gov't

MeSH terms

Antineoplastic Combined Chemotherapy Protocols / therapeutic use
Chemoradiotherapy
Head and Neck Neoplasms* / drug therapy
Head and Neck Neoplasms* / etiology
Humans
Induction Chemotherapy*
Retrospective Studies
Squamous Cell Carcinoma of Head and Neck / drug therapy
Squamous Cell Carcinoma of Head and Neck / etiology