Could Surgery be Better than Chemotherapy for some Patients with Tongue Cancer?

A recent study shows how surgery may be better than chemotherapy for some patients with tongue cancer.

According to researchers from the University of Michigan Comprehensive Cancer Center, show how chemotherapy may not be as good an option or potentially harm the patient's survival.

"To a young person with tongue cancer, chemotherapy may sound like a better option than surgery with extensive reconstruction. But patients with oral cavity cancer can't tolerate induction chemotherapy as well as they can handle surgery with follow-up radiation. Our techniques of reconstruction are advanced and offer patients better survival and functional outcomes," study author Douglas Chepeha, M.D., MSPH, professor of otolaryngology - head and neck surgery at the University of Michigan Medical School said, via press release.

Researchers enrolled 19 patients with advanced oral cavity cancer. All of the participants received an initial dose of chemotherapy known as induction therapy. Those who had success with the shrinking of the cancer tissues were also given an additional chemotherapy treatment along with radiation treatment. Those who did not respond to these treatments underwent surgery followed by radiation.

Researchers ended the enrollment trial early due to poor results.

The study notes the following regarding the findings, courtesy of the release: "Ten of the patients had a response to the chemotherapy, and of that group, only three had a complete response from the treatment and were cancer-free five years later. Of the nine patients who had surgery after the induction chemotherapy, only two were alive and cancer-free after five years."

Researchers then looked at a comparable group of patients that had also undergone surgery and a sophisticated reconstruction followed by radiation therapy. Results showed significantly survival rates and functional outcomes.

"The mouth is a very sensitive area," Chepeha said, via the release. "We know the immune system is critical in oral cavity cancer, and chemotherapy suppresses the immune system. If a person is already debilitated, they don't do well with chemotherapy."

"Despite the proven success of this strategy in laryngeal cancer, induction chemotherapy should not be an option for oral cavity cancer, and in fact it results in worse treatment-related complications compared to surgery."

More information regarding the study can be found via JAMA Otolaryngology Head and Neck Surgery.