For Head and Neck SCC, Radiation + Chemotherapy Provides Long-Term Benefits

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(ChemotherapyAdvisor) – Long-term follow-up of a select subgroup of patients with high-risk squamous cell carcinoma (SCC) of the head and neck found those treated with radiation therapy (RT) plus cisplatin had improved outcomes compared with those treated with RT alone, results of a study presented at the Multidisciplinary Head and Neck Cancer Symposium has found.

At a median follow-up of 9.4 years, an unplanned subset analysis of patients enrolled in the RTOG 9501/Intergroup phase 3 trial found the subgroup with microscopically involved resection and/or extracapsular spread of disease showed improved local-regional control with RT plus chemotherapy: 33.1% vs. 21% for RT alone (P=0.02); disease-free survival (DFS) was 18.4% vs. 12.3% (P=0.05) and overall survival (OS) was 27.1% vs 19.6% (P=0.07).

The study prospectively randomized 410 patients to radiation therapy (RT) 60 Gy in 6 weeks or identical RT plus cisplatin 100 mg/m2 IV days 1, 22, and 43. Jay S. Cooper, MD, of Maimonides Cancer Center, Brooklyn, NY, and colleagues noted that no significant differences in outcome were observed in an analysis of all randomized eligible patients. The local-regional failure rate was 28.8% for those treated with RT alone vs. 22.3% for the RT + cisplatin arm (P=0.10); DFS was 19.1% vs. 20.1% (P=0.25) and OS, 27% vs 29.1% (P=0.31), respectively.

Dr. Cooper said these results will allow patients to be stratified to provide benefits where indicated while sparing others unnecessary adverse events.

The Multidisciplinary Head and Neck Cancer Symposium is sponsored by the American Head and Neck Society, the American Society of Clinical Oncology, the American Society for Radiation Oncology, and the Society of Nuclear Medicine.

Abstract

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