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Induction Chemotherapy as a Prognostication Index and Guidance for Treatment of Locally Advanced Head and Neck Squamous Cell Carcinoma: the Concept of Chemo-Selection (KCSG HN13-01)

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Author(s)
Yun-Gyoo LeeEun Joo KangBhumsuk KeamJin-Hyuk ChoiJin-Soo KimKeon Uk ParkKyoung Eun LeeHyo Jung KimKeun-Wook LeeMin Kyoung KimHee Kyung AhnSeong Hoon ShinHye Ryun KimSung-Bae KimHwan Jung Yun
Keimyung Author(s)
Park, Keon Uk
Department
Dept. of Internal Medicine (내과학)
Journal Title
Cancer Res Treat
Issued Date
2022
Volume
54
Issue
1
Keyword
Locally advanced head and neck squamous cell carcinomaInduction chemotherapySubsequent treatment
Abstract
Purpose:
Certain patient subgroups who do not respond to induction chemotherapy (IC) show inherent chemoresistance in locally advanced head and neck squamous cell carcinoma (LA-HNSCC). This study aimed to assess the prognostic value of IC, and role of IC in guiding the selection of a definitive locoregional therapy.

Materials and Methods:
Out of the 445 patients in multi-institutional LA-HNSCC cohort, 158 (36%) receiving IC were enrolled. The study outcome was to assess overall survival (OS) through IC responsiveness and its role to select subsequent treatments.

Results:
Among 135 patients who completed subsequent treatment following IC, 74% responded to IC (complete response in 17% and partial response in 58%). IC-non-responders showed 4.5 times higher risk of mortality than IC-responders (hazard ratio [HR] 4.52, 95% confidence interval [CI] 2.32–8.81, p<0.001). Among IC-responders, 84% subsequently received definitive chemoradiotherapy (CCRT) and OS was not differed by surgery or CCRT (p=0.960). Regarding IC-non-responders, 54% received CCRT and 46% underwent surgery, and OS was poor in CCRT (24-month survival rate of 38%) or surgery (24-month survival rate of 63%).

Conclusion:
Response to IC is a favorable prognostic factor. For IC-responders, either surgery or CCRT achieved similar survival probabilities. For IC-non-responder, multi-disciplinary approach was warranted reflecting patients' preference, morbidity, and prognosis.
Keimyung Author(s)(Kor)
박건욱
Publisher
School of Medicine (의과대학)
Citation
Yun-Gyoo Lee et al. (2022). Induction Chemotherapy as a Prognostication Index and Guidance for Treatment of Locally Advanced Head and Neck Squamous Cell Carcinoma: the Concept of Chemo-Selection (KCSG HN13-01). Cancer Res Treat, 54(1), 109–117. doi: 10.4143/crt.2020.1329
Type
Article
ISSN
2005-9256
Source
https://www.e-crt.org/journal/view.php?number=3252
DOI
10.4143/crt.2020.1329
URI
https://kumel.medlib.dsmc.or.kr/handle/2015.oak/43994
Appears in Collections:
1. School of Medicine (의과대학) > Dept. of Internal Medicine (내과학)
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