Induction Chemotherapy as a Prognostication Index and Guidance for Treatment of Locally Advanced Head and Neck Squamous Cell Carcinoma: The Concept of Chemo-Selection (KCSG HN13-01)
- 주제(키워드) Locally advanced head and neck squamous cell carcinoma , Induction chemotherapy , Subsequent treatment
- 주제(기타) Oncology
- 설명문(일반) [Lee, Yun-Gyoo] Sungkyunkwan Univ, Kangbuk Samsung Hosp, Sch Med, Dept Internal Med, Seoul, South Korea; [Kang, Eun Joo] Korea Univ, Guro Hosp, Dept Internal Med, Seoul, South Korea; [Keam, Bhumsuk] Seoul Natl Univ Hosp, Dept Internal Med, 101 Daehak Ro, Seoul 03080, South Korea; [Choi, Jin-Hyuk] Ajou Univ Hosp, Dept Hematol Oncol, Suwon, South Korea; [Kim, Jin-Soo] SMG SNU Boramae Med Ctr, Dept Internal Med, Seoul, South Korea; [Park, Keon Uk] Keimyung Univ, Dongsan Med Ctr, Dept Hematooncol, Daegu, South Korea; [Lee, Kyoung Eun] Ewha Womans Univ Hosp, Dept Hematol & Oncol, Seoul, South Korea; [Kim, Hyo Jung] Hallym Univ, Sacred Heart Hosp, Dept Internal Med, Anyang, South Korea; [Lee, Keun-Wook] Seoul Natl Univ, Bundang Hosp, Coll Med, Dept Internal Med, Seongnam, South Korea; [Kim, Min Kyoung] Yeungnam Univ, Med Ctr, Dept Hematol Oncol, Daegu, South Korea; [Ahn, Hee Kyung] Gachon Univ, Gil Med Ctr, Dept Internal Med, Incheon, South Korea; [Shin, Seong Hoon] Kosin Univ, Gospel Hosp, Dept Internal Med, Busan, South Korea; [Kim, Hye Ryun] Yonsei Univ, Yonsei Canc Ctr, Coll Med, Dept Internal Med, Seoul, South Korea; [Kim, Sung-Bae] Univ Ulsan, Asan Med Ctr, Coll Med, Dept Internal Med, Seoul, South Korea; [Yun, Hwan Jung] Chungnam Natl Univ Hosp, Dept Internal Med, Daejeon, South Korea
- 등재 SCIE, SCOPUS, KCI등재
- OA유형 Green Published, gold
- 발행기관 KOREAN CANCER ASSOCIATION
- 발행년도 2022
- 총서유형 Journal
- URI http://www.dcollection.net/handler/ewha/000000190859
- 본문언어 영어
- Published As https://doi.org/10.4143/crt.2020.1329
- PubMed https://pubmed.ncbi.nlm.nih.gov/33940788
초록/요약
Purpose Certain patient subgroups who do not respond to induction chemotherapy (IC) show inherent chemoresistance in locally advanced head and neck squamous cell carcinoma (LA-HNSCC). This study aimed to assess the prognostic value of IC, and role of IC in guiding the selection of a definitive locoregional therapy. Materials and Methods Out of the 445 patients in multi-institutional LA-HNSCC cohort, 158 (36%) receiving IC were enrolled. The study outcome was to assess overall survival (OS) through IC responsiveness and its role to select subsequent treatments. Results Among 135 patients who completed subsequent treatment following IC, 74% responded to IC (complete response in 17% and partial response in 58%). IC-non-responders showed 4.5 times higher risk of mortality than IC-responders (hazard ratio, 4.52; 95% confidence interval, 2.32 to 8.81; p < 0.001). Among IC-responders, 84% subsequently received definitive concurrent chemoradiotherapy (CCRT) and OS was not differed by surgery or CCRT (p=0.960). Regarding IC-non-responders, 54% received CCRT and 46% underwent surgery, and OS was poor in CCRT (24-month survival rate of 38%) or surgery (24-month survival rate of 63%). Conclusion Response to IC is a favorable prognostic factor. For IC-responders, either surgery or CCRT achieved similar survival probabilities. For IC-non-responder, multidisciplinary approach was warranted reflecting patients' preference, morbidity, and prognosis.
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