Pathological responses to low-dose irradiation and Pepleomycin in Oral squamous cell carcinoma are predictive of Locoregional control.

Abstract

BACKGROUND:

The prognosis of advanced oral cancer remains dismal. While multimodal therapy is beneficial, maintaining the quality of life of long-term survivors is important. Therefore, risk-adapted treatment regimens need to be designed. We herein investigated whether pathological responses in oral cancer patients treated with preoperative chemoradiotherapy predict locoregional recurrence.

METHODS:

We retrospectively reviewed the data of 51 oral cancer patients who received preoperative radiotherapy and concurrent pepleomycin, followed by curative surgery at our institution between January 2009 and June 2018. Each patient received preoperative external beam irradiation to the primary tumor and lymphatics (2 Gy per day for approximately 3 weeks) concurrent with pepleomycin (2.5 mg/day). Surgery was performed approximately 3-4 weeks after the completion of preoperative chemoradiotherapy. Pathological responses were defined based on the grading system of Oboshi and Shimosato.

RESULTS:

Eight, 22, 16, and 5 patients had Oboshi and Shimosato grades 2a, 2b, 3, and 4, respectively. Favorable pathological responses (grades 3 and 4) were observed in 41.2% of patients (21 out of 51 patients). The pathological response and number of pathological lymph node metastases were identified as significant prognostic factors for locoregional control in the univariate analysis. Three-year locoregional control rates were 100 and 56.6% in patients with favorable and unfavorable pathological responses, respectively.

CONCLUSIONS:

The present study demonstrated that pathological tumor responses to preoperative chemoradiotherapy are a useful predictive factor for locoregional control.

• Authors: Tomohiro Katagiri, Yoshio Ohyama, Hideo Miyamoto, Yuki Egawa, Toshiaki Moriki, Kazuki Hasegawa
• Journal: BMC cancer (BMC Cancer) Vol. 20 Issue 1 Pg. 1216 (Dec 10 2020) ISSN: 1471-2407 [Electronic] England
• PMID: 33302897 (Publication Type: Journal Article)

Chemical References

• Peplomycin

Topics

• Adult
• Aged
• Aged, 80 and over
• Carcinoma, Squamous Cell (surgery, therapy)
• Chemoradiotherapy (adverse effects)
• Female
• Follow-Up Studies
• Hematologic Diseases (chemically induced)
• Humans
• Kaplan-Meier Estimate
• Lymphatic Irradiation
• Lymphatic Metastasis
• Male
• Middle Aged
• Mouth Neoplasms (surgery, therapy)
• Neck Dissection
• Neoadjuvant Therapy (adverse effects)
• Peplomycin (adverse effects, therapeutic use)
• Pneumonia, Aspiration (chemically induced)
• Radiotherapy Dosage
• Radiotherapy, Conformal (adverse effects)
• Retrospective Studies
• Treatment Outcome
• Xerostomia (chemically induced)