Abstract
Objectives
Concurrent chemoradiotherapy (CCRT) is one of recent emerging modalities for squamous cell carcinoma of the head and neck (SCCHN), because of its good efficacy and functional preservation. However, some patients treated by CCRT have residual tumor or recurrence in primary sites and/or cervical lymph nodes. This study aims to analyze usefulness of the salvage operations after CCRT for SCCHN.
Methods
The medical records of 111 consecutive patients (stage II: 17%, stage III: 6%, stage IV: 77%) treated with CCRT for SCCHN from 2003 through 2008 were reviewed. 76 patients were treated with 2 cycles of CDDP (60mg/m2), 5-FU (600mg/m2 ⋉ 4 days), and RT (2.0 Gy daily; total dose, 66–70Gy). 35 patients were treated with 6 cycles of weekly decetaxel (10mg/m2) and RT.
Results
The overall clinical response rate was 93% (59% complete, 34% partial). 16 patients underwent 23 surgical procedures. The types of procedures performed are as follows: selective neck dissection, 16; total laryngopharyngectomy, 3; total laryngectomy, 3; partial glossectomy, 1. All 16 patients with salvage operations had good locoregional controls as of 2007. Major wound complication (pharyngocutaneous fistula after total laryngectomy) occurred in 1 (6%) of 16 patients and successfully closed using deltopectoral flap. There were few other minor complications such as wound infection and laryngeal edema.
Conclusions
Salvage operations can be safely performed and considered to be useful in the point of locoregional control after intensive CCRT.
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