Abstract 437P
Background
Treatment strategy for very advanced unresectable head and neck squamous cell cancer (HNSCC) remains uncertain. Relevant guidelines suggest choosing between induction chemotherapy (ICT) followed by(chemo)radiotherapy (cRT) and concurrent chemoradiotherapy (CCRT). However, the role of ICT remains controversial considering the lack of overall survival benefit.
Methods
We performed a retrospective clinical study that included patients (pts) with unresectable stage III - IVa cancer of larynx, oropharynx and hypopharynx, who initiated ICT + cRT or CCRT since 01.01.2022 to 01.11.2023.
Results
A total of 176 pts were enrolled, 84 (48%) received CCRT with cisplatin or carboplatin and 92 (52%) – ICT with docetaxel, cisplatin and 5-fluorouracil for 3 cycles followed by cRT. The objective response rates were 75% in CCRT arm and 81% after completion of ICT + cRT (p=0.63). With a median follow-up duration of 8.7 months median progression-free survival (mPFS) was 7.6 and 9.4 months (Hazard ratio (HR) 0.67, 95% CI 0.43-1.04); 6-month OS was 65.7% and 92.8% in CCRT and ICT groups, respectively (HR 0.51, 95% CI 0.30-0.85, р=0.01). After propensity score matching analysis the mPFS was significantly longer in ICT + cRT group than in CCRTgroup (HR=0.41, 95% CI 0.22-0.76). OS in the ICT + cRT group was significantly longer than in CCRT group (HR=0.28, 95% CI 0.13-0.62). Pts with most benefit from ICT had T stage of 3-4 (HR=0.29, 95% CI 0.14-0.59) and tumor location in oropharynx (HR=0.32 95% CI 0.12-0.83).
Conclusions
ICT+сRT resulted in improvement of PFS and OS compared to CCRT in pts with locally advanced HNSCC. The major benefit from ICT was observed in pts with oropharyngeal cancer and large primary tumors.
Clinical trial identification
Editorial acknowledgement
Legal entity responsible for the study
The authors.
Funding
Has not received any funding.
Disclosure
All authors have declared no conflicts of interest.