A clinical study of oropharyngeal carcinoma. Chemoradioselection by TAR therapy

The data of 91 patients with oropharyngeal carcinoma treated at the University of Tsukuba Hospital between 2002 and 2011 were reviewed. The mean age (±standard deviation) was 62.5 (±10.2) years and the male-female ratio was 5.5 : 1. The tumor originated from the lateral wall in 58 cases (63.7%), the anterior wall in 22 cases (24.2%), the superior wall in 8 cases (8.8%), and the posterior wall in 3 cases (3.3%). Six cases were revealed to be positive for human papilloma virus (HPV) among the 7 cases examined. Only supportive care was administered in 12 cases. The remaining 79 cases were treated, and the disease-specific 5-year survival rate was 55.6%. Smoking and alcohol consumption were significantly related to the disease-specific survival rate. At our department, chemoradiotherapy is initiated with 45 Gy of radiation concurrently with a novel oral fluoropyrimidine derivative (Teysuno, Taiho Phamaceutical Co., Ltd.) and vitamin A (TAR therapy), to improve the rate of curative surgical resection and select appropriate candidates for further definitive chemoradiotherapy to allow organ preservation (chemoradioselection). Chemoselection by induction chemotherapy, or chemoradioselection by initial concurrent chemoradiotherapy is considered to be important to make individualized treatment selection for patients with oropharyngeal carcinoma, because of the highly variable response to definitive chemoradiotherapy among cases. (author)