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Adding cisplatin to radiotherapy after surgery for high-risk head and neck cancer improved local control and survival, and with the parallel American trial defined extranodal extension and positive margins as the indications for postoperative chemoradiation.
Phase 3 trial of 334 patients with resected stage III to IV head and neck squamous cell carcinoma with high-risk features randomised to postoperative radiotherapy alone or with three cycles of concurrent cisplatin.
Five-year progression-free survival was 47 versus 36 percent and overall survival 53 versus 40 percent with chemoradiation, with more severe acute mucositis; a combined analysis with RTOG 9501 showed the benefit was confined to patients with extranodal extension or positive margins.
Cisplatin chemoradiation after surgery is standard for extranodal extension or involved margins; radiotherapy alone suffices for other adverse features.
Shares Buccal mucosa and gingivobuccal cancer (oral cancer in India), Oral cavity cancer (mouth and tongue), HPV-negative head and neck squamous cell carcinoma (including HPV-negative oropharyngeal cancer), New England Journal of Medicine.
Shares Mucoepidermoid carcinoma, Oral tongue and floor of mouth cancer, Salivary duct carcinoma, Buccal mucosa and gingivobuccal cancer (oral cancer in India).
Shares Lip cancer, HPV-negative head and neck squamous cell carcinoma (including HPV-negative oropharyngeal cancer), New England Journal of Medicine.
Shares Oral tongue and floor of mouth cancer, Buccal mucosa and gingivobuccal cancer (oral cancer in India), Oral cavity cancer (mouth and tongue), New England Journal of Medicine.
Shares Oral tongue and floor of mouth cancer, Buccal mucosa and gingivobuccal cancer (oral cancer in India), Oral cavity cancer (mouth and tongue).
Shares Lip cancer, Oral tongue and floor of mouth cancer, Oral cavity cancer (mouth and tongue), HPV-negative head and neck squamous cell carcinoma (including HPV-negative oropharyngeal cancer).
Shares Oral tongue and floor of mouth cancer, Buccal mucosa and gingivobuccal cancer (oral cancer in India), Oral cavity cancer (mouth and tongue), HPV-negative head and neck squamous cell carcinoma (including HPV-negative oropharyngeal cancer).