Organ Preservation for Advanced Head and Neck Cancer Concomitant Chemoradiation
Treatment options for patients with locoregionally advanced head and neck cancer are now diverse. Surgery plus radiation or surgery plus chemoradiation remain options for patients with resectable disease. The same patients, however, appear to have an equally efficacious option of concomitant chemoradiation, with surgery reserved for salvage only. When performed in experienced settings, non-comparative data seem to indicate the outcome to be equivalent or perhaps even better. Direct comparisons between surgery and chemoradiation are unavailable. These would be extremely useful in terms of understanding optimal treatment, both in terms of cure, organ preservation, function preservation, and quality of life. All patients referred for resection of locoregionally advanced head and neck cancer should also have the option of concomitant chemoradiation discussed if an experienced treatment group is available to the patient.
KeywordsNeck Cancer Induction Chemotherapy Radiat Oncol Biol Phys Radiation Therapy Oncolgy Group Organ Preservation
Unable to display preview. Download preview PDF.
- 4.Induction chemotherapy plus radiation compared with surgery plus radiation in patients with advanced laryngeal cancer. The Department of Veterans Affairs Cancer Study Group. N Engl J Med 1991; 324:1685–1690.Google Scholar
- 6.Forastiere AA, Berkey B, Maor M, et al. Phase III trial to preserve the larynx: Induction chemotherapy and radiotherapy versus concomitant chemoradiotherapy versusu radiotherapy alone, Intergroup trial R91-11. Proc ASCO 2001;20:abstract 4.Google Scholar
- 7.Ku KK, Pajak TF, Trotti A, et al. A radiation therapy oncolgy group (RTOG) phase III randomized study to compare hyperfractionated and two variants of accelerated fractionation to standard fractionated radiotherapy for head and neck squamous cell carcinomas: First report of RTOG 9003. Int J Radiation Oncology Biol Phys 2000;48:7–16.Google Scholar
- 10.Bush RS, Jenkin RDT, Alh WEC et al: Definitive evidence for hypoxic cells influencing cure in cancer therapy. Br J Cancer 1978; 38(suppl 3):302Google Scholar
- 11.Weichselbaum RR, Little JB: Repair of potentially legal x-ray damage and possible applications to clinical radiotherapy. Int J Radiat Oncol Biol Phys 1993; 9:91Google Scholar
- 16.Head and Neck Contracts Program. Adjuvant chemotherapy for advanced head and neck squamous carcinoma. Final report of the head and neck contracts program. Cancer 1987;60:301–311Google Scholar
- 18.Adelstein DJ, Saxton JP, Lavertu P, et al. Maximizing local control and organ preservation in advanced squamous cell head and neck cancer (SCHNC) with hyperfractionated radiation (HRT) and concurrent chemotherapy. Proc ASCO 2001;20:224a, abstract 893.Google Scholar
- 19.Wendt TG, Grabenbauer GG, Rodel CM. Simultaneous radiotherapy versus radiotherapy alone in advanced head and neck cancer: A randomized multicenter study. J Clin Oncol 16:1318–1324Google Scholar
- 22.Calais G, Alfonsi M, Bardet E et al. Randomized trial of radiation versus concomitant chemotherapy and radiation for advanced-stage oropharynx carcinoma, J Natl Cancer Inst 1999; 15:2081–2086.Google Scholar
- 25.Rosen FR, Haraf DJ, Brockstein B, et al. Multicenter randomized phase II study of 1-hour infusion paclitaxel, fluorouracil and hydroxyurea with concomitant hyperfractionated radiotherapy (2XRT) with or without erythropoietin for advanced head and neck cancer. Proc ASCO 2001;20:226a, abstract 902Google Scholar