Abstract

Mohit Sharma*, Ketul Puj, Hemkant Verma and Shashank J. Pandya

ABSTRACT

Introduction: Head and Neck carcinoma constitutes 46% of all adult malignancies in India.. Most patients with squamous cell carcinoma of the head and neck present with locally advanced stage of III or IV. In patients treated with surgical resection and postoperative radiation, long term survival rates are generally low ranging from 30% to 40% To improve local resectability, to increase locoregional control, to decrease distant micro-metastasis and to maintain critical functions, the induction chemotherapy has been investigated. The use of chemotherapy provides the potential for better regional & distant tumor control. Aims and Objectives: The aim of this study is to compare the prognosis of patients who underwent neoadjuvant chemotherapy followed by surgery to that of those who underwent primary surgery. Although the number of patients studied here was small & the results were from only a single institution, this is controlled clinical study on the efficacy of neoadjuvant chemotherapy for locally advanced (T4a) squamous cell carcinoma of oral cavity. Material and Methods: It is a prospective comparative study performed at Gujarat Cancer and Research Institute Ahmedabad. Total 101 patients of locally advanced head and cancer were enrolled for study from November 2013 to April 2016.53 Patients were involved in upfront surgery arm and 48 patients were involved in neo addjuvent chemotherapy arm Conclusion: Neoadjuvent chemotherapy induces a high response rate that may facilitate definitive surgery in a borderline cases or where margin identification is difficult due to wet edematous borders of disease. Neoadjuvent chemotherapy is a feasible option in T4a squamous cell carcinoma of oral cavity with 70.83% cases without recurrence, with minimal addition and comparable morbidity and without mortality.