J Cancer Res Ther. 2025 Apr 1;21(3):567-575. doi: 10.4103/jcrt.jcrt_1317_24. Epub 2025 Jul 5.
ABSTRACT
INTRODUCTION: Patients diagnosed with oral cavity cancers (OCCs) often delay seeking medical attention and so always pose a challenge for oncologists. Typically, surgery is the preferred initial treatment option. However, surgical resection may not be feasible in cases of advanced disease. Conversely, radiotherapy (RT) and chemotherapy (CT) have not been widely used as alternatives to surgery for curative treatment or as neoadjuvant therapy.
OBJECTIVES: This study aims to evaluate the clinical and pathological responses at both primary and regional sites, post-op margin status, and postoperative morbidity in locally advanced borderline resectable oral cavity cancer patients treated with neoadjuvant chemoradiotherapy (NACRT).
METHODS: Fifty-seven patients presenting with locally advanced borderline resectable OCC were randomly assigned to Arm A (neoadjuvant chemoradiotherapy followed; surgery was performed after 2 to 6 weeks) and Arm B (definite surgery followed by adjuvant radiotherapy with or without chemotherapy).
RESULTS: In our study, out of 26 patients in Arm A, 3 (11.53%) and 16 (69.55%) had pathological complete responses at the primary and nodal sites, respectively, and 19 (73.77%) and 5 (21.75%) had partial responses at the primary and nodal sites, respectively. A significant difference was observed in margin negativity compared with the standard arm; 22 (84.60%) patients achieved negative margin post-NACRT. Postoperative morbidity was comparable in both arms.
CONCLUSION: The research findings indicate that the combination of NACRT and subsequent surgery is a viable option, resulting in favorable pathological complete responses. Given the significance of response to chemoradiotherapy as a prognostic indicator, these outcomes could potentially lead to improved disease-free survival rates in the future.
PMID:40616538 | DOI:10.4103/jcrt.jcrt_1317_24
