Feasibility and Efficacy of Neoadjuvant Chemoradiation in Lower Gingivobuccal Complex Cancers Involving Mandible

Abstract

Lower gingivobuccal complex cancers is the most common oral cavity cancers which has an increasing trend in India due to tobacco and alcohol intake. Aim of the Study: Assessment of feasibility and efficacy of Neoadjuvant chemoradiation in locally advanced gingivobuccal complex cancers involving mandible in achieving better clinical response and its impact on survival. Methods and Materials Inclusion Criteria Biopsy proven locally advanced gingivobuccal complex cancer patients with radiological confirmation of involvement of mandible and are fit for chemotherapy and surgery. Exclusion Criteria 1) Early stage Head and Neck cancer patients. 2) Patients unfit for surgery and chemotherapy Patient with locally advanced lower gingivobuccal complex cancers were taken for analysis after all investigsation done. Patient with disease considered as not resectable due to extensive soft tissue involvement were considered for neoadjuvant chemoradiation followed by which reassessment for surgery done. Patient will be given chemotherapy and radiotherapy for total dose of 50Gy using either conventional or conformal techniques. Patients will be reviewed at 50Gy for assessment for feasibility of surgery. Surgery considered if patient had resectable soft tissue component. Results: Out of 34 patients considered for Neoadjuvant chemoradiation 7 patients undergone surgery with no evidence of locoregional and distant metastases. Conclusion: Though we dont have clearcut indications for Neoadjuvant chemoradiotherapy it can be considered in selected subset of patients with extensive soft tissue disease for feasibility of surgery which has impact on locoregional and distant control and functional outcome .Larger studies should be done to assess the credibility of this study.