Impact of Induction Chemotherapy Before Radical Chemoradiation in Oral Cavity Squamous Cell Carcinoma: A Tertiary Centre Experience.

Advanced Oral Cavity Squamous Cell Carcinoma (OSCC) poses challenges for upfront resection. While surgery followed by adjuvant treatment is standard, induction chemotherapy is explored for better resectability and organ preservation. Its efficacy in unresectable cases is still uncertain and yet to be proven. A retrospective study was done at our institute by reviewing the institutional database from January 2018 to December 2020, where patients with biopsy proven OSCC who were considered unresectable disease but treated with curative intention recruited. All the patients recruited were divided into two cohorts: Radical CCRT (Arm A) or Induction Chemotherapy (IC) followed by Chemo Radiotherapy (CCRT) (Arm B) were evaluated. The patients were analyzed for progression free survival (PFS) and Overall Survival (OS). One hundred and eighty (180) patients of locally advanced unresectable OSCC were treated with curative intent. However, data of 22 (12%) patients were excluded because of incomplete data in the database. Of remaining 158 patients, 120 (76%) and 38 (24%) were divided into arm A and B, respectively. Baseline characteristics were statistically similar in both arms except for sub site distribution with higher percentage of buccal mucosa primary [25.8% vs 42.1% in arm A vs. B respectively, ]. With a median follow-up of 16 (range 2-73) months, the Progression Free Survival (PFS) observed was 11 vs. 12 months [-value 0.460] and Overall Survival (OS) was 16 vs. 17 months [-value 0.450] in arms A and B respectively. Our study showed IC doesn't have benefit in terms of PFS or OS compared to upfront CCRT in unresectable OSCC treated in a definitive setting. However, a more robust data and literature is required to come up with a clear answer for this clinical question.