Polychemotherapy in squamous cell carcinoma of the buccal mucosa

Carcinoma of the buccal mucosa

OBJECTIVE

The goal was to analyze the outcome of surgical therapy for buccal carcinoma.

STUDY DESIGN

A retrospective chart review was done.

SETTING

The study took place in a major tertiary-care hospital.

RESULTS

Twenty-seven patients received first-time surgical therapy for buccal carcinoma. Treatment was surgery alone in 15 and surgery followed by radiation therapy in 6 patients. Six additional patients received surgical salvage for radiation therapy failure. Composite resection of the tumor was performed in 16 patients (59%). Five-year observed actuarial survival rates were 100%, 45%, 67%, and 78%, and locoregional recurrence rates were 0%, 27%, 44%, and 0% for stages I to IV, respectively. The 5-year actuarial survival rates were 80% after surgery and 82% after surgery and postoperative radiation therapy. Patients who underwent surgical salvage after radiation therapy failure had a 1-year survival rate of 0%.

CONCLUSION

Aggressive surgical treatment of buccal carcinoma may result in better survival rates.

SIGNIFICANCE

The article analyzes buccal carcinoma in regards to the patterns of presentation, treatments rendered, and patterns of failure.

Treatment of advanced and/or metastatic epidermoid carcinoma of the head and neck: an effective combination chemotherapy with bleomycin, methotrexate and ftorafur

29 evaluable patients with advanced and/or metastatic epidermoid carcinomas of the head and neck were treated with a combination of bleomycin, methotrexate and ftorafur. 3 complete remission, 12 partial remission (objective response 51.7%), 10 stable disease and 4 progressed disease were obtained, with the best responses in the oral cavity and skin carcinomas. The grade of performance status and the pretreatments affected the response, with a very high response rate in nonpretreated patients, where objective results were obtained in all cases. The toxicity was very mild. We believe that this combination can be recommended for epidermoid carcinomas of the skin and oral cavity, considering its high response rate, feasibility and low toxicity.

Chemotherapy in buccal mucosa cancer

Twenty-five patients with previously untreated squamous cell carcinoma of the buccal mucosa were treated by two chemotherapeutic regimens. The first regimen consisted of administration of methotrexate (50 mg) intravenously at weekly intervals for 3 weeks. The second regimen consisted of bleomycin and methotrexate (BLM-MTX): Bleomycin 30 mg was given intravenously twice weekly and methotrexate 25 mg intravenously twice weekly for 2 1/2 and 2 weeks, respectively. Twenty-two of 25 cases were subjected to radical surgery following chemotherapy. When the two groups are compared, the number of cases responding to chemotherapy is about equal (70% and 73.4%). The observations suggest that the buccal cancers are highly sensitive to initial treatment with chemotherapy, and the authors recommend its use as preoperative adjunct therapy in patients who present with stage III and IV (Mo) disease.