This article is more than 5 years old. Information may no longer be current.
Accelerated concomitant radiation combined with cisplatin did not improve outcome in head and neck carcinoma
51st ASTRO Annual Meeting
In patients with locally advanced head and neck carcinoma, accelerated concomitant fractionation boost radiotherapy combined with cisplatin did not improve outcomes or increase late toxicity, according to the findings of phase-3 trial conducted by the Radiation Therapy Oncology Group.
K. Kian Ang, MD, PhD, professor of radiology oncology at the University of Texas M.D. Anderson Cancer Center, presented findings from the trial at the 51st ASTRO Annual Meeting, held in Chicago.
Ang and colleagues examined the efficacy and toxicity of concomitant fractionation boost radiotherapy and cisplatin vs. standard fractionation and cisplatin in 721 patients with locally advanced head and neck carcinoma.
At a median follow-up of 4.8 years, 418 patients were alive. Twelve patients in the accelerated concomitant boost group and seven patients in the standard fractionation group died of any cause with less than 30 days of therapy completed (P=.26). One death was related to accelerated concomitant boost therapy and two were related to standard fractionation therapy.
No differences were observed between the two groups for OS (HR=0.90, 0.72-1.13), DFS (P=.42), local-regional failure (P=.76) or metastasis (P=.06). In addition, there was no difference between the rate of overall grade-3 and grade-4 acute mucositis: 33% in the accelerated concomitant boost group vs. 40% in the standard fractionation therapy group.
In multivariate analyses, patients assigned to standard fractionation and cisplatin at a dose greater than 160 mg/m2 demonstrated better survival than those receiving smaller doses (HR=0.44; 0.27-0.73).
“Multivariate subset analysis revealed that HPV/p16+ oropharyngeal carcinoma is a distinct entity with better prognosis and should be studied separately and this is the plan of the Radiation Therapy Oncology Group,” Ang said during a presentation.
For more information:
- Ang K. Kian. #LB2. Presented at: 51st ASTRO Annual Meeting; Nov. 1-5, 2009, Chicago.
