ORIGINAL ARTICLE RESPONSE TO INTRAARTERIAL INDUCTION CHEMOTHERAPY: A PROGNOSTIC PARAMETER IN ORAL AND OROPHARYNGEAL CANCER

Abstract: Background. Patients with head and neck cancer and good pathologic response to neoadjuvant systemic induc-tion chemotherapy have a better prognosis for survival than do those with stable or progressive disease. Thus, induction chem-otherapy could theoretically help in stratifying further treatment, but toxicity is much too high. The prognostic implication of superselective intraarterial high-dose cisplatin administered by a femoral approach, which has much less toxicity, is not yet known. Methods. One hundred eighty-seven unselected consecu-tive patients with previously untreated oral and oropharyngeal squamous cell carcinoma received intraarterial high-dose cis-platin for induction and were assessed for response by visual examination and palpation. This treatment was followed by sur-gery and adjuvant radiation with concomitant systemic chemo-therapy. Omission of a modality depended on individual contra-indications and not on preselection. The consequence of omis-sions has been the constitution of several treatment arms. The overall and disease-free survival in relation to clinical local response after intraarterial induction chemotherapy was calcu-lated using the Kaplan–Meier method. Additional analysis ex-cluded bias caused by stages and treatment arms. Results. Explorative statistics using the log-rank and chi-square tests demonstrated a strong prognostic relevance of response to intraarterial chemotherapy irrespective of stage and treatment. Conclusions. Our results are encouraging for prospective randomized studies and molecular genetic investigations wit