A comparative analysis of neoadjuvant therapy versus upfront surgery for locally advanced oral and oropharyngeal squamous cell carcinoma
Objective The aim of this retrospective analysis is to investigate the survival and surgery benefits of combining neoadjuvant immunotherapy with chemotherapy in patients with locally advanced oral and oropharyngeal squamous cell carcinoma,by evaluating the clinical data of patients who received this combined treatment alongside upfront surgery.Methods Patients diagnosed with locally advanced oral and oropharyngeal squamous cell carcinoma,who underwent neoadjuvant chemoimmunotherapy or upfront surgery at our hospital between June 2021 and December 2022,were selected as the study cohort.The clinical data from both groups were collected to compare surgical indicators and prognosis.Results A total of 93 eligible patients were enrolled,including 33 in the experimental group and 60 in the control group.After neoadjuvant therapy,the major pathological response rate was 54.5％,with a 6％incidence of grade 3-4 adverse reactions.The trial group had a median follow-up time of 23 months,while the control group had a median follow-up time of 17 months.In terms of surgical outcomes,the experimental group exhibited significantly reduced operation time,intraoperative blood loss,operation cost,postoperative hospital days and number of large flap repairs compared to the control group.However,there were no significant differences in tracheotomy rate and postoperative complications between the two groups.Conclusion The findings of this study demonstrate the safety and feasibility of neoadjuvant therapy combining immunotherapy and chemotherapy.This treatment strategy can effectively decrease the duration of the surgery and reduce surgical trauma,while maintaining an unaltered prognosis.
Squamous cell carcinomaNeoadjuvant therapyImmunotherapyOral cancerOropharyngeal cancer
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