Role of Neo-Adjuvant Chemotherapy in Locally Advanced Oral Squamous Cell Carcinoma

Abstract

Digvijay Patil* and Kumar Nilesh

Introduction: The aim of this study was to compare the outcome of patients with locally advanced squamous cell carcinoma of buccal mucosa who underwent neoadjuvant chemotherapy (NACT) followed by surgery to that of those who underwent primary surgery. Materials and Methods: Total 50 patients with locally advanced buccal squamous cell carcinoma were randomly divided into in two groups with 25 patients in each. Patients in group I received neoadjuvant chemotherapy followed by surgery and radiotherapy, while patients in group II were only treated by surgery followed by radiotherapy. All the patients were assessed for demographic details, habit, clinical and histological grading of the tumour. Chemotherapy drug details, side effects, complications and response rate to NACT was studied. Type of surgery in terms of respectability, neck dissection and reconstruction modality was documented. Study of recurrence pattern in terms of local, regional and distant spread was evaluated. Result: age group of patient ranged from 30-60 years, with median age of 52, with a male to female ratio of 2:1 in group I and 3:1 in group II. Moderately differentiated SCC was the most common grade in both the groups. Post NACT, partial response was seen in 76% cases and complete response was seen in 8% cases. Study of recurrence pattern showed; 36% (9) local, 16% (4) regional and 8% (2) both local and regional in group I. In group II 16% (4) local, 16% (4) regional, 4% (1) both local and regional recurrence and 4% (1) distant metastasis was seen. Conclusion: NACT induces a high response rate that may facilitate definitive surgery in a borderline case or where margin identification is difficult due to wet edematous borders of disease. In the present study NACT showed partial response rate of 76% and complete response in 8% cases.