Neoadjuvant chemoimmunotherapy brings superior quality of life of patients with locally advanced oral or oropharyngeal cancer: A propensity score-matched analysis

IF 4 2区医学 Q1 DENTISTRY, ORAL SURGERY & MEDICINE

Oral oncology Pub Date : 2025-02-26 DOI:10.1016/j.oraloncology.2025.107218

Wen-Jie Wu , Pu-Gen An , Qian Liu , Zi-Qi Zhang , Xiao Hu , Jie Yao , Jie Zhang

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引用次数: 0

Abstract

Background

The outcomes and quality of life of patients with locally advanced oral or oropharyngeal squamous cell carcinoma (LAOOPSCC) following upfront surgery (US) are suboptimal. The optimal neoadjuvant therapy involving programmed death-1 inhibitors still remains unknown. We aimed to investigate the antitumor efficacy and quality-of-life benefits of neoadjuvant chemoimmunotherapy (NACI) and compare them with those of US for LAOOPSCC.

Methods

A total of 570 patients with OOPSCC who underwent surgical treatment between January 2021 and January 2023 were initially reviewed and we obtained 51 unbiased patients in each of the NACI and US groups through propensity score matching based on age, sex, clinical T and N stage. The antitumor efficacy in patients in the NACI group was evaluated with the pathological response. The postoperative quality of life, as assessed with the EORTC Quality of Life Questionnaire Head and Neck 35, as well as disease-free survival and overall survival, were compared between the groups.

Results

In the NACI group, the major pathological response rate was 58.8 % (30/51), and the objective response rate was 66.7 % (34/51). In NACI group, In the NACI group, patients experienced a shorter operative time (p = 0.001) and a reduced length of hospitalization post-surgery (p = 0.041), along with less intraoperative blood loss (p < 0.001) and fewer free flap reconstructions (p < 0.001). Compared with the patients in the US group, those in the NACI group had significantly better postoperative quality of life, including the sensory function (12.7 vs. 23.0, p = 0.021), speech problems (17.3 vs. 35.1, p < 0.001), social eating (20.8 vs. 31.0, p = 0.020), social contact (19.8 vs. 36.5, p < 0.001) and feeling ill (41.2 vs. 51.6, p = 0.021). There was no significant statistical difference in OS (p = 0.825) and DFS (p = 0.473) between the two groups.

Conclusion

The findings demonstrate the safety and feasibility of NACI and the de-escalation surgery after NACI is worth promoting to improve patient postoperative quality of life.

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来源期刊

Oral oncology 医学-牙科与口腔外科

CiteScore

8.70

自引率

10.40%

发文量

505

审稿时长

20 days

期刊介绍： Oral Oncology is an international interdisciplinary journal which publishes high quality original research, clinical trials and review articles, editorials, and commentaries relating to the etiopathogenesis, epidemiology, prevention, clinical features, diagnosis, treatment and management of patients with neoplasms in the head and neck. Oral Oncology is of interest to head and neck surgeons, radiation and medical oncologists, maxillo-facial surgeons, oto-rhino-laryngologists, plastic surgeons, pathologists, scientists, oral medical specialists, special care dentists, dental care professionals, general dental practitioners, public health physicians, palliative care physicians, nurses, radiologists, radiographers, dieticians, occupational therapists, speech and language therapists, nutritionists, clinical and health psychologists and counselors, professionals in end of life care, as well as others interested in these fields.