TABLE 90-27
Table 90-27. Randomized Trials of Neoadjuvant (Induction) Multiagent Chemotherapy for Head and Neck Cancer
Induction Therapy | % Disease-free Survival (yr)a | % Survival (yr)a | ||||||
Author | N | Regimen (no. of Cycles) | % Response (Complete) | Local Therapy | Control | Chemotherapy | Control | Chemotherapy |
| Petrovich528 | 23 | MLO (2) (ia) | 25 (0) | R | — | — | 9 (2) | 17 |
| Richard555 | 225 (oc, op) | OB (12d) | — | S ± R | — | — | — (3)b | — |
| Shetty612 | 42 (tb) | OBMFMc (2) | — | R | 50 (54) | 50 (0.58) | — | — |
| Stolwijk662 | 68 | VBMCF (2) | 21 (0) | S ± R | — | — | 77 (1) | 58 |
| Kun398 | 83 | CMBF (2) | 67(5) | R ± S | 64 (2) | 59 | 43 (2) | 31 |
| Szpirglas669 | 114 | DOBP (3) | 53 (11) | R | 3 (3+) | 5 | 5 (3+1) | 11 |
| Toohill691 | 60 | PF (3) | 85 (19) | R + S | 70 (2) | 70 | 70 (2) | 56 |
| Schuller594 | 158 | PMBO (3) | 70 (18) | S + R | 23 (5) | 23 | 28 (5) | 28 |
| Martin460 | 107 (oc, op) | PFBML (3) | 48 (6) | S + R; R | 42 (2) | 49f | — | — |
| Carugati96 | 120 | PB +/- M (1) | 44-59 (—) | — | 25 (5) | 33 | 18 (5) | 38 |
| Jauerry355 | 100 | PBVdMc (2) | 50 (10)-p | R | 38 (2) | 44 | 45 (2) | 34 |
| Vacsp699 | 322 (lc) | PF (2) | 85 (31) | R | — | — | 56 (3) | 53 |
| Martin456, 459 | 75 | PF (3) | 68 (46) | S + R; R | 61 (1) | 73 | — | — |
| Paccagnella514, 515 | 221 | PF (4) | 70 (29) | S + R | 58 | 62 | — | — |
| Martin455 | 218 (op) | CpF (3) | 81 (34) | S + R; R | 21 (2) | 22 | 60 (2) | 65 |
| P = cisplatin; Cp = carboplatin; F = 5-fluorouracil; M = methotrexate; L = leukovorin; B = bleomycin; O = vincristine; Vd = Videsine; Mc = mitomycin-C; R = radiotherapy; S = surgery; p, primary site; oc = oral cavity; op = oropharynx; tb = tongue base; lc = laryngeal cancer; ia = intraarterial. | ||||||||
| a Published values or estimated from published datacurves. | ||||||||
| b Reduction in local-regional recurrence (P < .05) in chemotherapy arm. | ||||||||
| c Freedom from local-regional recurrence (53 v 35%, P = .06). | ||||||||
| d Reduced distant metastasis rate in chemotherapy arm (P < .05). | ||||||||
| e Low-dose cisplatin (50mg/m2/cycle; distant metastases lower (49% v 28%, P = .07) in chemotherapy arm. | ||||||||
| f Disease-free survival favored control arm at 1 year (70 v 54%, P = .01). | ||||||||
| g 3-arm study—2 chemotherapy arms combined for analysis. |