대한두경부종양학회지 (Korean Journal of Head & Neck Oncology)

  • 제17권2호
  • /
  • Pages.179-184
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  • 2001
  • /
  • 1229-5183(pISSN)
  • /
  • 2586-2553(eISSN)
대한두경부종양학회 (The Korean Society for Head and Neck Oncology)
권호 표지

국소 진행성 구강암에서 선행 항암 화학 요법의 효과

The Therapeutic Effect of Neoadjuvant Chemotherapy in Locally Advanced Oral Cavity Cancer

  • 조요한 (서울대학교 의과대학 내과학교실) ;
  • 최인실 (서울대학교 의과대학 내과학교실) ;
  • 이근욱 (서울대학교 의과대학 내과학교실) ;
  • 오도연 (서울대학교 의과대학 내과학교실) ;
  • 김병수 (서울대학교 의과대학 내과학교실) ;
  • 이대호 (서울대학교 의과대학 내과학교실) ;
  • 김태유 (서울대학교 의과대학 내과학교실) ;
  • 방영주 (서울대학교 의과대학 내과학교실) ;
  • 우홍균 (서울대학교 의과대학 치료방사선과학교실) ;
  • 성명훈 (서울대학교 의과대학 이비인후과학교실) ;
  • 이철희 (서울대학교 의과대학 이비인후과학교실) ;
  • 김광현 (서울대학교 의과대학 이비인후과학교실) ;
  • 허대석 (서울대학교 의과대학 내과학교실)
  • Joh Yo-Han (Department of Internal Medicine, Seoul National University, College of Medicine) ;
  • Choi In-Sil (Department of Internal Medicine, Seoul National University, College of Medicine) ;
  • Lee Keun-Wook (Department of Internal Medicine, Seoul National University, College of Medicine) ;
  • Oh Do-Youn (Department of Internal Medicine, Seoul National University, College of Medicine) ;
  • Kim Byung-Su (Department of Internal Medicine, Seoul National University, College of Medicine) ;
  • Lee Dae-Ho (Department of Internal Medicine, Seoul National University, College of Medicine) ;
  • Kim Tae-You (Department of Internal Medicine, Seoul National University, College of Medicine) ;
  • Bang Yung-Jue (Department of Internal Medicine, Seoul National University, College of Medicine) ;
  • Wu Hong-Gyun (Department of Therapeutic Radiology, Seoul National University, College of Medicine) ;
  • Sung Myung-Whun (Department of Otorhinolaryngology, Seoul National University, College of Medicine) ;
  • Lee Chul-Hee (Department of Otorhinolaryngology, Seoul National University, College of Medicine) ;
  • Kim Kwang-Hyun (Department of Otorhinolaryngology, Seoul National University, College of Medicine) ;
  • Heo Dae-Seog (Department of Internal Medicine, Seoul National University, College of Medicine)
  • 발행 : 2001.11.01
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초록

Objective: The role of chemotherapy in locally advanced head and neck cancer has been established in nasopharynx and larynx as definitive therapy and organ preserving therapy, respectively. Oral cavity cancers are relatively uncommon and local recurrence is the main cause of treatment failure. We planned this retrospective study to evaluate the role of neoadjuvant chemotherapy in locally advanced oral cavity cancer patients. Materials and Methods: From 1988 March to 2001 February, locally advanced, previously untreated oral cavity cancer patients who received neoadjuvant chemotherapy were examined. Chemotherapy had been done in the following patients: Histologically proven squamous cell or poorly differentiated carcinoma, stage 3 or 4, and performance state 0-2 patients. Chemotherapy regimen consisted of cisplatin and infusional 5-fluorouracil. Response was evaluated after 2 cycles and in case of no response, definitive local therapy was done; otherwise 3 cycles was done before local treatment. Results: 48 patients were treated and 47 patients were evaluable for responses. Complete response rate was 6.4%(3/47) and partial response 80.0%(38/47), scoring overall response rate of 87.2%. Median time to progression was 27.0 months (95% CI : 0-58months) and overall 5 year survival was 54.8%. 5-year disease-free survival in the patients in remission after local treatment was 51.9%. In multivariate analysis, contributing factor to the survival were response to neoadjuvant chemotherapy and local treatment modalities. Extensive surgery was done in 10 patients and 25 patents (52.1%) was followed up with preserved function. With median follow-up of 57.0 months, 19 recurrences were detected, most of which were local or regional type. Conclusion: Neoadjuvant chemotherapy followed by local treatment in oral cavity cancer showed high response rate and was thought to be effective therapeutic approach especially in view of organ preservation.

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