The role of sequential chemoradiation for local advanced oropharyngeal carcinoma.

BACKGROUND: This study aims to assess survival, prognostic indicators, and pattern of failure for advanced oropharyngeal cancer treated by induction chemotherapy followed by concomitant chemoradiation (sequential CRT). METHODS: A retrospective review of 80 consecutive patients who underwent chemoradiation [doublet cisplatin and 5-fluorouracil (PF)] for local advanced oropharyngeal carcinoma at a tertiary center from March 2003 to July 2008 is reported. Seven studies utilizing a similar protocol were reviewed, and all outcomes are collated. RESULT: At a median follow-up of 32 months, the 3-year overall survival was 75%. Tumor size (p < 0.001), age at presentation (p < 0.002), and failure to complete the full course of induction chemotherapy (p < 0.01) were all found to be significant factors affecting survival. CONCLUSION: Induction chemotherapy followed by concomitant chemoradiation utilizing doublet PF is an effective treatment for local advanced oropharyngeal carcinoma. At present, the addition of a taxane to the PF regimen cannot be assumed to provide benefit until further evidence emerges from a representative controlled trial.