Chemotherapy improves survival in mouth and throat cancer

January 01, 0001

Chemotherapy improves survival in mouth and throat cancer

Clinical Question: How effective is chemotherapy, in addition to radiotherapy and/or surgery, for oral and oropharyngeal cancer?

Bottom line: Chemotherapy, in addition to radiotherapy and surgery, was associated with improved overall survival in patients with oral cavity and oropharyngeal cancers. Induction chemotherapy may prolong survival by 8 to 20% and adjuvant concomitant chemoradiothera.py may prolong survival by up to 16%. In patients with unresectable tumours, concomitant or alternating chemoradiotherapy may prolong survival by 10 to 22%.

Caveat: There is insufficient evidence as to which agent or regimen is most effective. And the additional toxicity (nausea, vomiting, diarrhoea, hair loss and infections) associated with chemotherapy, given in addition to radiotherapy and/or surgery, cannot be quantified.

Context: Treatment of oral cavity cancer is, generally, surgery, followed by radiotherapy, whereas oropharyngeal cancers, which are more likely to be advanced at the time of diagnosis, are managed with radiotherapy or chemoradiation. Surgery for oral cancers can be disfiguring, and both surgery and radiotherapy have significant functional side-effects, notably impaired ability to eat, drink and talk. The development of new chemotherapy agents, new combinations of agents, and changes in the relative timing of surgery, radiotherapy and chemotherapy treatments may, potentially, bring about increases in both survival and quality of life for this group of patients.

Cochrane Systematic Review: Furness S et al. Interventions for the treatment of oral cavity and oropharyngeal cancer: chemotherapy. Cochrane Reviews, 2011, Issue 4. Article No. CD006386. DOI:10.1002/14651858. CD006386.pub3. This review contains 89 studies involving 16,767 participants.

Cochrane PEARLS Practical Evidence About Real Life Situations. No. 319, July 2011.
Written by Brian R McAvoy. Published by the Cochrane Primary Care Group

Category: D. Digestive. Keywords: oral cancer, throat cancer, mouth, chemotherapy, survival
Synopsis edited by Dr Linda French, Toledo, Ohio. Posted on Global Family Doctor 4 October 2011

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Pearls are an independent product of the Cochrane primary care group and are meant for educational use and not to guide clinical care.