Significance of neoadjuvant immunotherapy combined with chemotherapy in the treatment of larynx preservation in locally advanced hypopharyngeal squamous cell carcinoma.
10.13201/j.issn.2096-7993.2023.09.006
- Author:
Jin WU
1
;
Guohua HU
1
;
Minmin LI
2
;
Zhihai WANG
1
;
Wei MA
1
;
Xiaoqiang WANG
1
;
Jiang ZHU
1
;
Min PAN
1
;
Quan ZENG
1
Author Information
1. Department of Otorhinologyngology，the First Affiliated Hospital of Chongqing Medical University，Chongqing，400016，China.
2. Department of Oncology，the First Affiliated Hospital of Chongqing Medical University.
- Publication Type:Journal Article
- Keywords:
hypopharyngeal neoplasms;
larynx-preservation;
neoadjuvant chemotherapy;
neoadjuvant immunotherapy
- MeSH:
Humans;
Squamous Cell Carcinoma of Head and Neck/etiology*;
Neoadjuvant Therapy;
Quality of Life;
Cisplatin;
Treatment Outcome;
Antineoplastic Combined Chemotherapy Protocols/therapeutic use*;
Larynx;
Head and Neck Neoplasms;
Immunotherapy
- From:
Journal of Clinical Otorhinolaryngology Head and Neck Surgery
2023;37(9):715-728
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To evaluate the clinical significance of neoadjuvant immunotherapy combined with chemotherapy in the treatment of larynx preservation in locally advanced hypopharyngeal squamous cell carcinoma. Methods:Patients with locally advanced HPSCC（cT3-T4aN0-N3M0） were eligible. All received 2 cycles of pembrolizumab combined with docetaxel and platinum neoadjuvant induction therapy. After two cycles, the efficacy was evaluated, followed by radical chemoradiotherapy or surgery and adjuvant chemoradiotherapy according to the efficacy. The primary endpoints were objective response rate（ORR） ，larynx-preservation（LP） rate at 3 months post-treatment and the adverse reactions during neoadjuvant therapy. Results:From December 2021 to December 2022, 10 patients with locally advanced HPSCC（cT3-T4aN0-N3M0） were enrolled. After 2 cycles of the neoadjuvant therapy, 2 patients achieved complete response（CR）, 7 patients achieved partial response（PR）, 1 patient was stable disease（SD）, objective response rate（ORR） was 90%, and disease control rate（DCR） was 100%. 5 patients received radical chemoradiotherapy, 5 patients received surgery and adjuvant chemoradiotherapy, four of them received partial laryngectomy and partial hypopharyngeal resection surgery, and one of them received total laryngectomy and partial hypopharyngeal resection surgery. All patients were able to withstand adverse reactions of neoadjuvant therapy and successfully completed the whole treatment of HPSCC without grade 3-4 treatment-related adverse reactions. There was no recurrence or metastasis during 3-18 months of follow-up. 1 patient died of severe pneumonia 3 months after the completion of radical chemoradiotherapy. At 3 months after treatment, the larynx-preservation rate was 80%. Conclusion:Neoadjuvant immunotherapy combined with chemotherapy has good short-term efficacy and the adverse reactions were tolerable. It can improve the larynx-preservation rate of patients with locally advanced HPSCC, thus improving the prognosis and quality of life of patients.
