Effect of afatinib combined with induction chemotherapy on primary tumor regression and safety of surgical margins in locally advanced oral cancer.

OBJECTIVE: To explore the impact of afatinib in combination with induction chemotherapy on primary tumor regression, surgical margin security, and long-term prognostic outcomes in patients with locally advanced oral cancer (LAOC). METHODS: A retrospective study was performed on 218 LAOC patients admitted to The Second Hospital of Lanzhou University and Integrated Traditional Chinese and Western Medicine Hospital of Tianshui City from 2016 to 2019, assigned to a combination group (afatinib + TPF, n=115) and a control group (TPF alone, n=103). Tumor regression (RECIST 1.1, pathological grading), positive margin rate, tumor markers, adverse reactions, and 5-year survival were analyzed and compared; Logistic and COX regression models were used to analyze risk factors. RESULTS: Combination group had higher ORR (70.43% vs. 57.28%, P=0.043), DCR (93.04% vs. 75.73%, P<0.001) and tumor regression ≥90% (33 vs. 16 cases, P<0.05), lower positive margin rate (14.78% vs. 37.86%, P<0.001), reduced postoperative tumor markers (all P<0.05), and better 5-year OS/DFS (all P<0.001). Afatinib combination was a protective factor for margin and survival, with no significant adverse responses (P>0.05). CONCLUSION: Afatinib combined with induction chemotherapy enhances tumor regression effect, boosts surgical margin security, and lowers tumor marker levels without elevating adverse event risks, which acts as an effective neoadjuvant strategy for LAOC.