Response to induction chemotherapy as a prognostic indicator in locally advanced head and neck squamous cell carcinoma.

Abstract

Purpose: Induction chemotherapy (IC) for patients with locally advanced stage Head and Neck Squamous Cell Carcinomas (HNSCC) before radio-chemotherapy (RCT) or surgery remains a potential treatment option. This study analyzed how the response to IC correlates with survival outcomes.

Methods: We conducted a retrospective single-center study at a tertiary cancer center. Tumors were categorized by anatomical site and response to IC (non-responders vs. responders). Data were analyzed using Kaplan-Meier survival curves and Cox regression analysis.

Results: A total of 48 patients received IC. Of these, 33 patients were radiologically evaluable for response. The majority of evaluable patients received either TPF (Docetaxel, Cisplatin, 5-Fluorouracil) (58%) or TP (Docetaxel, Cisplatin) (24%) as their IC regimen. Tumor reduction of 30% or more was observed in 23 patients (69.7%), the tumor control rate was 97%. The 2-year event-free survival (EFS) in the IC evaluable population was 53.1%, overall survival (OS) was 63.6%, and recurrence-free survival (RFS) was 62.5%. Patients with laryngeal or hypopharyngeal tumors that did not respond to IC had a significantly poorer prognosis. This effect was not statistically significant in tumors of the oral cavity or oropharynx, where it was only observed as a trend.

Conclusion: IC is highly effective in treating locally advanced stage HNSCC. The response to IC is prognostic for survival, particularly in cancers of the larynx and hypopharynx.