Efficacy and Prognosis of Neoadjuvant Therapy for Locally Advanced Head and Neck Squamous Cell cancer
CHENG Shuai
ZHANG Yuan
Abstract：Objective To evaluate the efficacy and prognosis of multimodal comprehensive therapy for locally advanced head and neck squamous cell cancer based on surgery.Methods The clinical data of 204 patients with stage Ⅲ-Ⅳb head and neck squamous cell cancer ( including oral cavity,oropharynx,larynx,and hypopharynx) were analyzed.Patients were divided into three groups,neoadjuvant chemotherapy group ( TPF group),targeted combined chemotherapy neoadjuvant therapy group (C-TPF group) and direct surgery group according to different preoperative treatment methods.All patients received radiation treatment after surgery.The overall survival,progression-free survival,local-regional recurrence-free survival and distant recurrence-free survival in patients with locally advanced head and neck squamous cell cancer,and functional preservation rates in patients with laryngeal and hypopharyngeal cancer under different treatment modes were compared between the three groups.Results 52 patients were included in the TPF group,with 3-year overall survival rate (OS) of 57.5％,5-year OS of 43.1％,8-year OS of 39.8％,and the preservation rate of laryngeal function in patients with laryngeal and hypopharyngeal cancer was 81.8％(36/44).64 patients were included in the C-TPF group,with 3-year OS of 68.6％,3-year OS of 65.6％,and the preservation rate of laryngeal function in patients with laryngeal and hypopharyngeal cancer was 81.6％( 40/49) .81 patients were included in the direct surgery group,with 3-year OS of 53.6％,5-year OS of 44.9％,8-year OS of 35.1％ and the preservation rate of laryngeal function in patients with laryngeal and hypopharyngeal cancer was 54.23％.C-TPF group showed remarkable improvement in OS (P=0.005),PFS (P=0.002),and distant recurrence free survival (P=0.001) compared to surgery group,and significantly improved OS ( P=0.025) and distant recurrence free survival compared to the TPF group ( P=0.02).Subgroup analysis showed that for patients with laryngeal cancer,C-TPF group had remarkable improvement in OS compared to TPF group ( P=0.021) and surgery group ( P=0.038),and also has remarkable improvement in distant recurrence free survival compared to TPF group ( P=0.040) and surgery group ( P=0.031) .For patients with hypopharyngeal cancer,C-TPF group had remarkable improvement in OS compared to TPF group (P=0.022) and surgery group (P=0.003),C-TPF group also had remarkable improvement in distant recurrence free survival compared to TPF group ( P=0.021) and surgery group ( P=0.021) .In terms of laryngeal function preservation,the preservation rate of laryngeal function in the C-TPF ( P=0.003) and TPF group ( P=0.003) was significantly enhanced compared to the direct surgery group.Treatment-related adverse reactions can be controlled by modifying the TPF regimen.Conclusions For locally advanced head and neck squamous cell cancer,compared with the direct surgery or TPF neoadjuvant therapy alone plus postoperative radiotherapy,C-TPF neoadjuvant therapy plus postoperative radiotherapy can improve overall survival and distant recurrence free survival.Preoperative neoadjuvant therapy for laryngeal cancer and hypopharyngeal cancer is more conducive to the preservation of laryngeal function than direct surgery.
Keywords：Locally advanced head and neck squamous cell cancerCetuximabTPF induction chemotherapySurgeryRadiotherapy
Publication Date：2024-12-20
Online Publishing Date：2025-08-15(First online date of this platform, not the publication date of the document)
Pages：8( 547-553,559 )