Abstract
The aim of this study was to evaluate retrospectively the outcomes of patients with stage IV advanced oral and maxillofacial cancer (OMFC) primarily treated with induction chemotherapy using TPF (TPF-ICT), and the efficacies of salvage surgical treatment. Forty-nine cases were treated with TPF-ICT. The therapy is very effective against OMFC, but the side effects are very severe.
The response rate for primary region and cervical region cancers were 57.1% and 65%, respectively.
The most commonly observed Grade 3-4 side effects included leucopenia (75.5%), hemoglobin decrease (32.7%), and thrombocytopenia (22.4%). Other toxicities included renal failure, nausea, vomiting, and diarrhea. Neuropathy was diagnosed in 19 (38%) patients.
If the response is poor or the side effects are severe, the therapy will be followed by another therapy such as radiotherapy or surgical therapy. Six cases received salvage surgery following TPF-RT (radiotherapy) and 31 cases received salvage surgery following TPF alone.
Patients with OMFC who received salvage surgery following TPF alone (31 cases) and CCRT-HFT (42 cases) were compared. The operation time, hemorrhage volume, complications, and success rate of free flap were not different in the two groups.
In the two groups (TPF-ICT vs. CCRT-HFT), survival analysis after salvage surgery was performed using the Kaplan-Meier method and the 2- and 3-year overall survival rates were (70.5% vs. 52.1%) and (59.2% vs. 50%), respectively.
The efficacy of TPF-ICT against advanced OMFC was suggested in this study.
