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Chemoradiotherapy not superior to radiotherapy in locally advanced head and neck squamous cell carcinoma

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2011 ASTRO Annual Meeting

MIAMI - Preoperative concurrent chemoradiotherapy did not improve OS in patients with locally advanced head and neck squamous cell carcinoma, but did improve metastasis-free survival of locally advanced hypopharyngeal and laryngeal carcinoma.

Junlin Yi, MD, and colleagues from the Cancer Hospital, Chinese Academy of Medical Sciences in Beijing, conducted a phase-3 study to compare preoperative concurrent chemoradiotherapy with preoperative radiotherapy alone.

The study included 168 patients with locally advanced head and neck squamous cell carcinoma. They were randomly assigned to preoperative concurrent chemoradiotherapy (n=83) or preoperative radiotherapy alone (n=85). The chemotherapy regimen included cisplatin 30 mg/m² weekly. The radiotherapy dose was the same between both groups.

If the tumor response was in remission or nearly complete remission, the patient continued with chemoradiotherapy or radiotherapy. If not, the patient underwent surgery. N1-N2 patients continued to receive chemoradiotherapy or radiotherapy to the neck if the tumor response was in remission or nearly complete remission. N3 patients received a planned neck dissection regardless of the response.

For the preoperative chemoradiotherapy group, the 5-year local control rate was 63%, the OS rate was 45.7%, the disease-free survival rate was 40.8% and the distant metastasis-free survival rate was 75.7%. In the preoperative radiotherapy alone group, the 5-year local control rate was 49.7%, the OS rate was 38.2%, the DFS rate was 5.2% and the distant metastasis-free survival rate was 64.9%. These differences were not significant.

In a subgroup analysis, the 2-year distant metastasis-free survival in the concurrent chemoradiotherapy group was 88.2% and 60.3% in the radiotherapy alone group (P=.014).

For more information:

• Yi J. #155. Presented at: the 53rd ASTRO Annual Meeting; Oct. 2-6, 2011; Miami Beach, Fla.

Disclosure: Dr. Yi reports no relevant financial disclosures.

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