Induction Chemotherapy as a Prognostication Index and Guidance for Treatment of Locally Advanced Head and Neck Squamous Cell Carcinoma: The Concept of Chemo-Selection (KCSG HN13-01)

Yun Gyoo Lee; Eun Joo Kang; Bhumsuk Keam; Jin Hyuk Choi; Jin Soo Kim; Keon Uk Park; Kyoung Eun Lee; Hyo Jung Kim; Keun Wook Lee; Min Kyoung Kim; Hee Kyung Ahn; Seong Hoon Shin; Hye Ryun Kim; Sung Bae Kim; Hwan Jung Yun

doi:10.4143/CRT.2020.1329

Induction Chemotherapy as a Prognostication Index and Guidance for Treatment of Locally Advanced Head and Neck Squamous Cell Carcinoma: The Concept of Chemo-Selection (KCSG HN13-01)

Yun Gyoo Lee, Eun Joo Kang, Bhumsuk Keam, Jin Hyuk Choi, Jin Soo Kim, Keon Uk Park, Kyoung Eun Lee, Hyo Jung Kim, Keun Wook Lee, Min Kyoung Kim, Hee Kyung Ahn, Seong Hoon Shin, Hye Ryun Kim, Sung Bae Kim, Hwan Jung Yun

Department of Internal Medicine

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7 Scopus citations

Abstract

Purpose Certain patient subgroups who do not respond to induction chemotherapy (IC) show inherent chemoresistance in locally advanced head and neck squamous cell carcinoma (LA-HNSCC). This study aimed to assess the prognostic value of IC, and role of IC in guiding the selection of a definitive locoregional therapy. Materials and Methods Out of the 445 patients in multi-institutional LA-HNSCC cohort, 158 (36%) receiving IC were enrolled. The study outcome was to assess overall survival (OS) through IC responsiveness and its role to select subsequent treatments. Results Among 135 patients who completed subsequent treatment following IC, 74% responded to IC (complete response in 17% and partial response in 58%). IC-non-responders showed 4.5 times higher risk of mortality than IC-responders (hazard ratio, 4.52; 95% confidence interval, 2.32 to 8.81; p < 0.001). Among IC-responders, 84% subsequently received definitive concurrent chemoradiotherapy (CCRT) and OS was not differed by surgery or CCRT (p=0.960). Regarding IC-non-responders, 54% received CCRT and 46% underwent surgery, and OS was poor in CCRT (24-month survival rate of 38%) or surgery (24-month survival rate of 63%). Conclusion Response to IC is a favorable prognostic factor. For IC-responders, either surgery or CCRT achieved similar survival probabilities. For IC-non-responder, multidisciplinary approach was warranted reflecting patients’ preference, morbidity, and prognosis.

Original language	English
Pages (from-to)	109-117
Number of pages	9
Journal	Cancer Research and Treatment
Volume	54
Issue number	1
DOIs	https://doi.org/10.4143/CRT.2020.1329
State	Published - Jan 2022

Bibliographical note

Publisher Copyright:
Copyright © 2022 by the Korean Cancer Association.

Keywords

Induction chemotherapy
Locally advanced head and neck squamous cell carcinoma
Subsequent treatment

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10.4143/CRT.2020.1329

Cite this

Lee, Y. G., Kang, E. J., Keam, B., Choi, J. H., Kim, J. S., Park, K. U., Lee, K. E., Kim, H. J., Lee, K. W., Kim, M. K., Ahn, H. K., Shin, S. H., Kim, H. R., Kim, S. B., & Yun, H. J. (2022). Induction Chemotherapy as a Prognostication Index and Guidance for Treatment of Locally Advanced Head and Neck Squamous Cell Carcinoma: The Concept of Chemo-Selection (KCSG HN13-01). Cancer Research and Treatment, 54(1), 109-117. https://doi.org/10.4143/CRT.2020.1329

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title = "Induction Chemotherapy as a Prognostication Index and Guidance for Treatment of Locally Advanced Head and Neck Squamous Cell Carcinoma: The Concept of Chemo-Selection (KCSG HN13-01)",

abstract = "Purpose Certain patient subgroups who do not respond to induction chemotherapy (IC) show inherent chemoresistance in locally advanced head and neck squamous cell carcinoma (LA-HNSCC). This study aimed to assess the prognostic value of IC, and role of IC in guiding the selection of a definitive locoregional therapy. Materials and Methods Out of the 445 patients in multi-institutional LA-HNSCC cohort, 158 (36%) receiving IC were enrolled. The study outcome was to assess overall survival (OS) through IC responsiveness and its role to select subsequent treatments. Results Among 135 patients who completed subsequent treatment following IC, 74% responded to IC (complete response in 17% and partial response in 58%). IC-non-responders showed 4.5 times higher risk of mortality than IC-responders (hazard ratio, 4.52; 95% confidence interval, 2.32 to 8.81; p < 0.001). Among IC-responders, 84% subsequently received definitive concurrent chemoradiotherapy (CCRT) and OS was not differed by surgery or CCRT (p=0.960). Regarding IC-non-responders, 54% received CCRT and 46% underwent surgery, and OS was poor in CCRT (24-month survival rate of 38%) or surgery (24-month survival rate of 63%). Conclusion Response to IC is a favorable prognostic factor. For IC-responders, either surgery or CCRT achieved similar survival probabilities. For IC-non-responder, multidisciplinary approach was warranted reflecting patients{\textquoteright} preference, morbidity, and prognosis.",

keywords = "Induction chemotherapy, Locally advanced head and neck squamous cell carcinoma, Subsequent treatment",

author = "Lee, {Yun Gyoo} and Kang, {Eun Joo} and Bhumsuk Keam and Choi, {Jin Hyuk} and Kim, {Jin Soo} and Park, {Keon Uk} and Lee, {Kyoung Eun} and Kim, {Hyo Jung} and Lee, {Keun Wook} and Kim, {Min Kyoung} and Ahn, {Hee Kyung} and Shin, {Seong Hoon} and Kim, {Hye Ryun} and Kim, {Sung Bae} and Yun, {Hwan Jung}",

note = "Publisher Copyright: Copyright {\textcopyright} 2022 by the Korean Cancer Association.",

year = "2022",

month = jan,

doi = "10.4143/CRT.2020.1329",

language = "English",

volume = "54",

pages = "109--117",

journal = "Cancer Research and Treatment",

issn = "1598-2998",

publisher = "Korean Cancer Association",

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Lee, YG, Kang, EJ, Keam, B, Choi, JH, Kim, JS, Park, KU, Lee, KE, Kim, HJ, Lee, KW, Kim, MK, Ahn, HK, Shin, SH, Kim, HR, Kim, SB & Yun, HJ 2022, 'Induction Chemotherapy as a Prognostication Index and Guidance for Treatment of Locally Advanced Head and Neck Squamous Cell Carcinoma: The Concept of Chemo-Selection (KCSG HN13-01)', Cancer Research and Treatment, vol. 54, no. 1, pp. 109-117. https://doi.org/10.4143/CRT.2020.1329

Induction Chemotherapy as a Prognostication Index and Guidance for Treatment of Locally Advanced Head and Neck Squamous Cell Carcinoma: The Concept of Chemo-Selection (KCSG HN13-01). / Lee, Yun Gyoo; Kang, Eun Joo; Keam, Bhumsuk et al.
In: Cancer Research and Treatment, Vol. 54, No. 1, 01.2022, p. 109-117.

Research output: Contribution to journal › Article › peer-review

TY - JOUR

T1 - Induction Chemotherapy as a Prognostication Index and Guidance for Treatment of Locally Advanced Head and Neck Squamous Cell Carcinoma

T2 - The Concept of Chemo-Selection (KCSG HN13-01)

AU - Lee, Yun Gyoo

AU - Kang, Eun Joo

AU - Keam, Bhumsuk

AU - Choi, Jin Hyuk

AU - Kim, Jin Soo

AU - Park, Keon Uk

AU - Lee, Kyoung Eun

AU - Kim, Hyo Jung

AU - Lee, Keun Wook

AU - Kim, Min Kyoung

AU - Ahn, Hee Kyung

AU - Shin, Seong Hoon

AU - Kim, Hye Ryun

AU - Kim, Sung Bae

AU - Yun, Hwan Jung

PY - 2022/1

Y1 - 2022/1

N2 - Purpose Certain patient subgroups who do not respond to induction chemotherapy (IC) show inherent chemoresistance in locally advanced head and neck squamous cell carcinoma (LA-HNSCC). This study aimed to assess the prognostic value of IC, and role of IC in guiding the selection of a definitive locoregional therapy. Materials and Methods Out of the 445 patients in multi-institutional LA-HNSCC cohort, 158 (36%) receiving IC were enrolled. The study outcome was to assess overall survival (OS) through IC responsiveness and its role to select subsequent treatments. Results Among 135 patients who completed subsequent treatment following IC, 74% responded to IC (complete response in 17% and partial response in 58%). IC-non-responders showed 4.5 times higher risk of mortality than IC-responders (hazard ratio, 4.52; 95% confidence interval, 2.32 to 8.81; p < 0.001). Among IC-responders, 84% subsequently received definitive concurrent chemoradiotherapy (CCRT) and OS was not differed by surgery or CCRT (p=0.960). Regarding IC-non-responders, 54% received CCRT and 46% underwent surgery, and OS was poor in CCRT (24-month survival rate of 38%) or surgery (24-month survival rate of 63%). Conclusion Response to IC is a favorable prognostic factor. For IC-responders, either surgery or CCRT achieved similar survival probabilities. For IC-non-responder, multidisciplinary approach was warranted reflecting patients’ preference, morbidity, and prognosis.

AB - Purpose Certain patient subgroups who do not respond to induction chemotherapy (IC) show inherent chemoresistance in locally advanced head and neck squamous cell carcinoma (LA-HNSCC). This study aimed to assess the prognostic value of IC, and role of IC in guiding the selection of a definitive locoregional therapy. Materials and Methods Out of the 445 patients in multi-institutional LA-HNSCC cohort, 158 (36%) receiving IC were enrolled. The study outcome was to assess overall survival (OS) through IC responsiveness and its role to select subsequent treatments. Results Among 135 patients who completed subsequent treatment following IC, 74% responded to IC (complete response in 17% and partial response in 58%). IC-non-responders showed 4.5 times higher risk of mortality than IC-responders (hazard ratio, 4.52; 95% confidence interval, 2.32 to 8.81; p < 0.001). Among IC-responders, 84% subsequently received definitive concurrent chemoradiotherapy (CCRT) and OS was not differed by surgery or CCRT (p=0.960). Regarding IC-non-responders, 54% received CCRT and 46% underwent surgery, and OS was poor in CCRT (24-month survival rate of 38%) or surgery (24-month survival rate of 63%). Conclusion Response to IC is a favorable prognostic factor. For IC-responders, either surgery or CCRT achieved similar survival probabilities. For IC-non-responder, multidisciplinary approach was warranted reflecting patients’ preference, morbidity, and prognosis.

KW - Induction chemotherapy

KW - Locally advanced head and neck squamous cell carcinoma

KW - Subsequent treatment

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SN - 1598-2998

VL - 54

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Induction Chemotherapy as a Prognostication Index and Guidance for Treatment of Locally Advanced Head and Neck Squamous Cell Carcinoma: The Concept of Chemo-Selection (KCSG HN13-01)

Abstract

Bibliographical note

Keywords

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