Elsevier

The Lancet Oncology

Volume 12, Issue 2, February 2011, Pages 113-114
The Lancet Oncology

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Induction chemotherapy in head and neck cancer: closer to an answer?

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  • Laryngo-esophageal dysfunction free survival and propensity score matched analysis comparing organ preservation and total laryngectomy in hypopharynx cancer

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    However, their LDFS rate included ‘the presence of natural speech, absence of a tracheostomy, absence of a feeding tube for ≥2 years after treatment or recurring pneumonia that required hospitalization’. Despite the improved results following induction CT with TPF, concerns regarding dose limiting toxicity compromising the concurrent component have prevented this from becoming standard of care [30]. While a recent meta-analysis analyzing induction CT followed by concurrent CRT in head and neck cancer demonstrated a significant improved disease control and complete response rate, they were unable to demonstrate significant improved OS rate in patients treated with induction CT [31].

  • Neck lymph node metastases from unknown primary

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    The concomitant approach has actually became the standard of care in locally advanced head and neck cancer in the past decade. Regimens using TPF (docetaxel, cisplatin, and fluorouracil) may be better than those with PF (cisplatin and fluorouracil) [103,104] but the topic remains debated [105]. As mentioned earlier, it’s been possible to identify two prognostic clinico-pathologic CUP subgroups [106], but the heterogeneous outcome and behaviour is still the distinguishing characteristic of CUP patients.

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