What question did this study set out to answer?

To determine whether adding concomitant cisplatin to postoperative radiotherapy improves disease control and survival compared with radiotherapy alone in resected stage III or IV head and neck cancer.

May 5, 2004New England Journal of MedicineOpen Access

Postoperative Irradiation with or without Concomitant Chemotherapy for Locally Advanced Head and Neck Cancer

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To determine whether adding concomitant cisplatin to postoperative radiotherapy improves disease control and survival compared with radiotherapy alone in resected stage III or IV head and neck cancer.
Randomized trial of 334 patients after curative-intent surgery, randomly assigned to receive radiotherapy alone (66 Gy over 6.5 weeks, N=167) or radiotherapy combined with cisplatin (100 mg/m² on days 1, 22, and 43; N=167).
Patients were evaluated over a median follow-up period of 60 months.
Combined therapy significantly improved 5-year progression-free survival compared to radiotherapy alone (47% vs. 36%; HR 0.75; 95% CI, 0.56 to 0.99; P=0.04) and 5-year overall survival (53% vs. 40%; HR 0.70; 95% CI, 0.52 to 0.95; P=0.02).
The 5-year cumulative incidence of local or regional relapse was significantly lower in the combined-therapy group than in the radiotherapy group (18% vs. 31%; P=0.007).
Severe adverse effects (grade ≥3) occurred in 41% of patients receiving combined therapy versus 21% receiving radiotherapy alone (P=0.001), while late adverse effect rates were similar.

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Implication

Randomized trial shows improved survival with adjuvant cisplatin plus radiotherapy in advanced head and neck cancer, highlighting superior tumor control despite higher acute toxicity.

Cite This Study

Bernier et al. (2004) studied this question.

synapsesocial.com/papers/69ff73eab124fe5819856fa5 https://doi.org/10.1056/nejmoa032641

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Implication

Randomized trial shows improved survival with adjuvant cisplatin plus radiotherapy in advanced head and neck cancer, highlighting superior tumor control despite higher acute toxicity.

Postoperative Irradiation with or without Concomitant Chemotherapy for Locally Advanced Head and Neck Cancer

Key Points

Discussion

Implication

Cite This Study

Postoperative Irradiation with or without Concomitant Chemotherapy for Locally Advanced Head and Neck Cancer

Key Points

Discussion

Implication

Cite This Study