Objective: The role of induction chemotherapy in the multidisciplinary treatment of locally advanced, nonlaryngeal high-risk human papilloma virus (HPV)-negative head and neck squamous cells carcinoma (HNSCC) is uncertain in terms of overall survival (OS). The primary objective of this study was to identify possible predictive factors of survival and outcome in patients with HNSCC who were treated with induction chemotherapy. Methods: Fifty-nine patients with stage IVa/b HPV-negative non-laryngeal HNSCC (mostly originating from the oral cavity) who underwent induction chemotherapy at Policlinico Umberto I were reviewed. Treatment outcomes in term of objective response rate (ORR), progression-free survival (PFS), OS and toxicities were analyzed. Results: A significant association between nodal status, ORR, ongoing smoking use, toxicities and OS was demonstrated. ORR (obtained in 61% of patients) was associated with a reduction in mortality of 80% (P < 0.0001). Early discontinuation after just one cycle of induction chemotherapy was associated to a significantly shorter OS. In oral cavity radical surgery with negative margins was obtained in 15/16 patients. In 42% of patients G3-G4 toxicity occurred. Toxicity requiring hospitalization occurred in 42% and 21% of patients with oropharyngeal and oral cavity carcinoma, respectively. Five patients died of treatment-related causes. No treatment-related mortality occurred in oral cavity patients. G5 toxicities were different according to the sub-sites of disease (P = 0.05). Conclusion: Induction chemotherapy in non-laryngeal high-risk HNSCC is an active strategy, most importantly in oral cavity cancer, even though burdened with a high (G ≥ 3) toxicity and early discontinuation rate. These data will however need to be confirmed in further and larger studies.

Induction chemotherapy in nonlaryngeal human papilloma virus-negative high-risk head and neck cancer: a real-world experience / Mezi, Silvia; Pomati, Giulia; Botticelli, Andrea; Roberto, Michela; Cerbelli, Bruna; Cirillo, Alessio; Di Gioia, Cira; Corsi, Alessandro; Vullo, Francesco; De Vincentiis, Marco; Polimeni, Antonella; Tombolini, Vincenzo; Valentini, Valentino; Marchetti, Paolo. - In: ANTI-CANCER DRUGS. - ISSN 0959-4973. - Publish Ahead of Print:(2020), pp. 1-10. [10.1097/CAD.0000000000000977]

Induction chemotherapy in nonlaryngeal human papilloma virus-negative high-risk head and neck cancer: a real-world experience

Mezi, Silvia
Primo
Writing – Original Draft Preparation
;
Pomati, Giulia
Secondo
;
Botticelli, Andrea;Roberto, Michela;Cerbelli, Bruna;Cirillo, Alessio;Di Gioia, Cira;Corsi, Alessandro;Vullo, Francesco;De Vincentiis, Marco;Polimeni, Antonella;Tombolini, Vincenzo;Valentini, Valentino
Penultimo
;
Marchetti, Paolo
Ultimo
2020

Abstract

Objective: The role of induction chemotherapy in the multidisciplinary treatment of locally advanced, nonlaryngeal high-risk human papilloma virus (HPV)-negative head and neck squamous cells carcinoma (HNSCC) is uncertain in terms of overall survival (OS). The primary objective of this study was to identify possible predictive factors of survival and outcome in patients with HNSCC who were treated with induction chemotherapy. Methods: Fifty-nine patients with stage IVa/b HPV-negative non-laryngeal HNSCC (mostly originating from the oral cavity) who underwent induction chemotherapy at Policlinico Umberto I were reviewed. Treatment outcomes in term of objective response rate (ORR), progression-free survival (PFS), OS and toxicities were analyzed. Results: A significant association between nodal status, ORR, ongoing smoking use, toxicities and OS was demonstrated. ORR (obtained in 61% of patients) was associated with a reduction in mortality of 80% (P < 0.0001). Early discontinuation after just one cycle of induction chemotherapy was associated to a significantly shorter OS. In oral cavity radical surgery with negative margins was obtained in 15/16 patients. In 42% of patients G3-G4 toxicity occurred. Toxicity requiring hospitalization occurred in 42% and 21% of patients with oropharyngeal and oral cavity carcinoma, respectively. Five patients died of treatment-related causes. No treatment-related mortality occurred in oral cavity patients. G5 toxicities were different according to the sub-sites of disease (P = 0.05). Conclusion: Induction chemotherapy in non-laryngeal high-risk HNSCC is an active strategy, most importantly in oral cavity cancer, even though burdened with a high (G ≥ 3) toxicity and early discontinuation rate. These data will however need to be confirmed in further and larger studies.
2020
oropharyngeal carcinoma; oral cavity carcinoma; cancer patients
01 Pubblicazione su rivista::01a Articolo in rivista
Induction chemotherapy in nonlaryngeal human papilloma virus-negative high-risk head and neck cancer: a real-world experience / Mezi, Silvia; Pomati, Giulia; Botticelli, Andrea; Roberto, Michela; Cerbelli, Bruna; Cirillo, Alessio; Di Gioia, Cira; Corsi, Alessandro; Vullo, Francesco; De Vincentiis, Marco; Polimeni, Antonella; Tombolini, Vincenzo; Valentini, Valentino; Marchetti, Paolo. - In: ANTI-CANCER DRUGS. - ISSN 0959-4973. - Publish Ahead of Print:(2020), pp. 1-10. [10.1097/CAD.0000000000000977]
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Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/11573/1440797
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