Induction Chemotherapy Followed by Radiation Therapy Versus Surgery Followed by Concurrent Chemo-Radiation Therapy in Locally Advanced Squamous Cell Carcinoma of the Oral Cavity

Abstract

Introduction Squamous cell carcinoma of the oral cavity is one of the top 10 malignancies reported globally. Pakistan has a high incidence of oral cancers due to the prevailing poor lifestyle habits/addictions of Pakistanis, and most patients with squamous cell carcinoma present with stage III or IV locally advanced disease. Recommended guidelines indicate surgery as the mainstay of treatment followed by radiotherapy (RT). The addition of induction chemotherapy before surgery or radiation therapy might improve outcomes with increased locoregional control rates. Methods This was a retrospective cohort study comparing the outcomes between surgery followed by concurrent chemoradiotherapy (CCRT) and induction chemotherapy followed by RT. This study primarily aimed to evaluate progression-free survival (PFS) and determine the toxicity of chemotherapy. Results We found out that the mean PFS among patients undergoing surgery and CCRT and those receiving induction chemotherapy followed by RT were 6.40 (± 2.38) months and 7.6 (± 4.76) months, respectively. Conclusion Induction chemotherapy with docetaxel, cisplatin, and 5-fluorouracil followed by RT shows satisfactory results with acceptable toxicity. However, the results are not statistically significant but support the already published data on this treatment aspect of oral cavity cancers.