Induction chemotherapy resulted in good disease control for patients with cancer at the base of the tongue, according to data from a small study at the University of Oklahoma. The value of induction chemotherapy in these patients remains controversial, however, and is the subject of four ongoing phase III clinical trials.
Explore this issue:May 2008
Physicians have traditionally treated patients with cancer at the base of the tongue (BOT) with surgery or, more recently, with concurrent chemoradiation. Several research groups hypothesize that treating these patients with chemotherapy before concurrent chemoradiation may reduce the mass of the tumor, decreasing the amount of chemoradiation necessary to cure the tumor and potentially improving overall survival.
To learn whether induction chemotherapy works in their own center, Jesus E. Medina, MD, Professor and Chairman of the Department of Otorhinolaryngology at the University of Oklahoma, and colleagues enrolled 18 patients with stage III or IV BOT cancer in a single-institution cohort study. Patients received up to three cycles of induction chemotherapy every 21 days, including 175 mg/m2 paclitaxel, 60 mg/m2 cisplatin, and 1000 mg/m2 ifosfamide. Following induction chemotherapy, patients received seven weeks of concurrent chemoradiation with paclitaxel and carboplatin. Patients who showed no response after two induction cycles were referred to surgery and adjuvant radiation. Patients who had a complete response after two cycles progressed immediately to concurrent chemoradiation, skipping the third induction cycle.