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
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
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.