Sivakumari, S (2014) To assess the efficacy of Neoadjuvant chemotherapy in locally advanced resectable squamous cell cancers of the oral cavity. Masters thesis, Kilpauk Medical College, Chennai.
|
Text
180700414sivakumari.pdf Download (1MB) | Preview |
|
|
Text
180700414sivakumari_images.pdf Download (625kB) | Preview |
|
![[img]](http://repository-tnmgrmu.ac.in/style/images/fileicons/other.png) |
Spreadsheet
180700414sivakumari_work_sheet.xlsx Download (16kB) |
Abstract
INTRODUCTION: Around 5,00,000 cases of cancer of the head and neck are diagnosed annually around the world out of which 2, 63,000 are oral cancers and every year 1, 27,000 people die because of it. It is the sixth most common cancer worldwide. In south-central Asia, cancer of the oral cavity is one of the three most common cancers. Incidence rates for oral cancer vary from 1 to 10 cases per 100,000 population in men. The incidence of oropharyngeal cancers significantly increased among men during 1983 to 2002 predominantly in economically developed countries like the United States, Australia, Canada, Japan, and Slovakia, while the incidence of oral cavity cancers remained the same according to the Cancer Incidence in Five Continents database. Among women, in all countries with increasing oropharyngeal cancer incidence there was a concomitant increase in incidence of oral cavity cancers. In the United States, the overall incidence peaked at 12.7 per 100,000 person-years in 1980–1985 before declining (11%) to 11.3 in 1998–2003 and then rose to 12.0 in 2004–2008. AIM OF THE STUDY: Aims of this study were: 1. To assess the efficacy of Neoadjuvant chemotherapy in locally advanced resectable squamous cell cancers of the oral cavity. 2. To compare the efficacy and toxicities of two different drug regimens, Cisplatin and 5-Fluorouracil (PF regimen) and Paclitaxel and Cisplatin (TP regimen). METHODS: Patients with histologically confirmed non metastatic locally advanced resectable squamous cell carcinoma of the oral cavity were included in the study. Pretreatment evaluation included: 1. History, 2. Physical examination, 3. Biopsy, 4. Complete blood analysis, 5. Chest X-ray, 6. Tumour imaging by means of contrast enhanced CT of the head and neck. Inclusion criteria: 1. Age 18-70 years, 2. WHO performance status < 2, 3. Stages III and IVA (T3, N0-N2 and T4a, N0-N2). Normal haematologic and renal function Hb > 10g ; adequate bone marrow reserve (total count > 4,000/μl, platelet count > 10,000/μl ); normal blood urea and creatinine. 4. A normal chest X-ray, 5. No masticator space, or pterygoid muscle, or infratemporal or skull base involvement on CECT. Exclusion criteria: 1. Histologies other than invasive squamous cell carcinoma, 2. Metastasis, 3. Recurrent/Residual disease/second primary cancers, 4. Patients who received any prior treatment for the disease, 5. Other medical illness(es) precluding full study participation. CONCLUSION: 1. Preoperative chemotherapy containing two drug regimen in locally advanced resectable squamous cell carcinoma of the oral cavity is ineffective in reducing the tumour volume and the stage of the disease. 2. Paclitaxel with cisplatin combination chemotherapy yields significantly better response rates than 5FU and cisplatin. However, the response rates are inferior compared to the standard three drug regimen currently recommended. 3. Neoadjuvant chemotherapy does not improve the prognosis and is not recommended in initial management of locally advanced resectable squamous cell carcinoma of the oral cavity.
| Item Type: | Thesis (Masters) |
|---|---|
| Additional Information: | Reg.No.18114154 |
| Uncontrolled Keywords: | Neoadjuvant chemotherapy, locally advanced resectable squamous cell cancers, oral cavity. |
| Subjects: | MEDICAL > Surgical Oncology |
| Depositing User: | Subramani R |
| Date Deposited: | 16 Feb 2020 10:59 |
| Last Modified: | 21 Feb 2020 23:50 |
| URI: | http://repository-tnmgrmu.ac.in/id/eprint/11964 |
Actions (login required)
 |
View Item |
