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Poster Display session

457P - Induction chemotherapy: Hope or hype in head & neck cancer – Real-world evidence from Institute of National importance in Western Rajasthan (India)

Date

07 Dec 2024

Session

Poster Display session

Presenters

Atul Gupta

Citation

Annals of Oncology (2024) 35 (suppl_4): S1554-S1574. 10.1016/annonc/annonc1692

Authors

A.K. Gupta

Author affiliations

  • Radiation Oncology Department, AIIMS - All India Institute of Medical Sciences, Jodhpur, 342005 - Jodhpur/IN

Resources

This content is available to ESMO members and event participants.

Abstract 457P

Background

Head and neck cancers are malignant tumors of the upper aerodigestive tract including the oral cavity, nasopharynx, oropharynx, hypopharynx, and larynx. Squamous cell carcinoma constitutes for >90% of HNCs. The study was conducted with an aim to assess multiple clinic-pathological factors associated with outcome in Head & Neck Cancer patients. As Induction Chemotherapy is considered to be an integral part of head and neck cancer management, this study focuses on induction chemotherapy and its association with survival outcomes.

Methods

The records of head and neck cancer patients who received definitive/adjuvant Radiotherapy in our Department from 2018 to 2020 were compiled and various factors associated with outcome were assessed. Effect of induction chemotherapy on survival outcome in various subsites was assessed using Kaplan Meier Curve and Log Rank Test.

Results

Total 130 patients with proper records were analysed. Mean age of presentation was 52 years, Male predominant, 85 patients were oral cavity, 15 were pharyngeal subsites, 20 were laryngeal subsite, 15 with Stage I, 20 with stage II, 19 with stage III, 74 with stage IVA, 2 with stage IVB. Out of 130 patients, 36 received NACT, out of which 25 received Doublet while 11 received triplet chemotherapy. Survival Analysis of patients with operable oral cavity cancer who received NACT or who underwent upfront surgery was done using Kaplan Meier analysis and Median OS was 25 months in NACT arm vs 14.9 months in non-NACT arm (p=0.01). In Pharyngeal tumors who got treated wither Radical RT alone or CTRT, Median OS in RT alone arm was 13 months, 14 months in CTRT arm while 17 months in NACT f/b CTRT arm. (p=0.07). Overall, In all HNC subsites, median OS was 17 months in NACT arm vs 20 months in non-NACT arm (p=0.76).

Conclusions

In country like India where Head and Neck Cancers are quite common and mostly present in locally advanced stage, Induction Chemotherapy seems to be a valid option helping in downstaging of the disease and filling the gap between patient presentation and its definitive management either surgery or Definitive Radiotherapy. However, its effect on survival outcome is still debatable which needs to be confirmed in further large-scale trials.

Clinical trial identification

Editorial acknowledgement

Legal entity responsible for the study

The author.

Funding

Has not received any funding.

Disclosure

The author has declared no conflicts of interest.

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