Survival after chemotherapy with cisplatin and infusion of bleomycin prior to local-regional treatment in pyriform sinus cancer
Grau, J.J.; Cuchi, A.; Estapé, J.; Arias, C.; Mañé, J.M.; Fírvida, J.L.; Moreno, F.; Traserra, J.
Tumori 82(3): 221-224
1996
ISSN/ISBN: 0300-8916 PMID: 8693597 Document Number: 458118
Aims and background: The purpose of the study was to retrospectively compare different approaches including neoadjuvant chemotherapy. Methods: Ninety-six consecutive patients with pyriform sinus squamous cell carcinoma with no distant metastases were entered. The first 48 patients were treated with surgery plus postoperative radiation therapy (50-60 Gy) over cervical lymphatics. The next 48 patients were treated by induction chemotherapy with two courses of cisplatin, 120 mg/m-2 .v. day one, plus bleomycin, 20 mg/m-2/day for 5 consecutive days in 24-hr .v. perfusion followed by definitive surgery and postoperative radiation therapy as in the first therapeutic group. Results: Definitive surgery was performed in 38 control vs 39 neoadjuvant patients. Complete response was observed in 9 (18.7%) and partial response in 32 (66.7%) of 48 chemotherapy-treated patients. Partial plus complete response was seen in 41 (85.4%) of the 48 patients. Comparison between controls versus chemotherapy-treated groups showed persistence of the disease in 10 vs 9 patients; local-regional relapses in 21 versus 14 patients; and distant metastases in 4 vs 2 patients. Median survival was 12 vs 40 months. Survival curves were statistically better in neoadjuvants than in controls (P lt 0.025). Conclusions: Multidisciplinary therapy slightly decreases the rate of local-regional relapses and distant metastases and should improve survival in this set of pyriform sinus cancer patients.