Neoadjuvant Chemotherapy Followed by Surgery-A Promising Strategy to Reduce Morbidity in Locally Advanced Tongue...

Area of Science:

• Oncology
• Head and Neck Surgery

Background:

• Neoadjuvant chemotherapy (NACT) has uncertain survival benefits in oral cancers.
• The specific role of NACT in tongue cancer requires further investigation.

Purpose of the Study:

• To evaluate the efficacy of NACT in locally advanced oral tongue cancer (Stage III-IVB).
• To assess response rates, surgical extent, and oncological outcomes following NACT.

Main Methods:

• Retrospective analysis of 72 patients with locally advanced oral tongue cancer.
• Comparison between patients receiving NACT (n=20) and upfront surgery (n=52).
• Assessment of response rates, tumor downstaging, surgical procedures, and survival data.

Main Results:

• NACT, primarily TPF regimen, achieved an 85% clinical benefit rate with partial response in 65% of patients.
• Tumor downstaging occurred in 70% of NACT patients, enabling less extensive surgery in 42.9%.
• Mandibular preservation rate was 75% in the NACT group; pathological complete response was 10%.

Conclusions:

• NACT demonstrates potential for tumor downstaging and improved response rates in locally advanced tongue cancer.
• NACT may facilitate less extensive surgical procedures, including mandibular preservation.
• While NACT showed benefits in response and surgical approach, survival outcomes were comparable to upfront surgery in this study.