Correlation Between Response to Induction Chemotherapy and Subsequent Radiotherapy in Previously Untreated Patients with Squamous Cell Carcinomas of the Head and Neck

Park, Woo Yoon; Yoo, Seong Yul; Koh, Kyoung Hwan; Cho, Chul Koo; Park, Young Hwan; Shim, Youn Sang; Oh, Kyung Kyoon; Lee, Yong Sik

Abstract

To determine the correlation between the response to induction chemotherapy and subsequent radiotherapy we analyzed the clinical records of 60 patients with locally advanced carcinoma of the head and neck retrospectively who had completed a full course (2~3 cycle) of induction chemotherapy and curative radiotherapy in Korea Cancer Center Hospital between 1986 and 1989. Chemotherapy was administered with CDDP+Bleomycin (BP) in 20, CDDP+5-FU (FP) in 37, and hybrid of BP and FP in three patients. Radiotherapy was given conventionally with a dose of 65 to 75 gy or more over seven to eight weeks according to the size of lesion. Response rates following induction chemotherapy were 80% for the tumors and 79% for the nodes whereas complete response rates were 12% and 13%, respectively. Six months after radiotherapy 67% of the tumors and 77% of the nodes achieved a complete response. Among the 48 tumor responders and the 31 nodal responders to chemotherapy, 39 (81%) and 28 (90%), respectively, achieved complete response after radiotherapy. Thus, whether or not the tumor and node respond to induction chemotherapy was predictive of the response to subsequent radiotherapy (p<0.0005 in tumor, p<0.0001 in node). By reanalyzing according to disease subsets (i.e. primary site, T-stage, N-stage) this relationship was not observed at T1-T2 disease (p>0.3). Therefore the tumor or node's response to induction chemotherapy is a predictor for subsequent radiotherapy except in T1-T2 tumors, and complete response to radiotherapy can be expected despite the failure of induction chemotherapy in T1-T2 tumors.