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In this American trial, adding cisplatin to postoperative radiotherapy for high-risk head and neck cancer improved local control and disease-free survival but not overall survival, and doubled severe toxicity.
Phase 3 trial of 459 patients with resected high-risk head and neck squamous cell carcinoma (two or more involved nodes, extracapsular extension or positive margins) randomised to postoperative radiotherapy alone or with concurrent cisplatin.
Locoregional control at two years was 82 versus 72 percent (hazard ratio 0.61) and disease-free survival was improved (hazard ratio 0.78), but overall survival did not differ significantly; grade 3 or worse adverse events were 77 versus 34 percent. Long-term follow-up confirmed benefit only in patients with extracapsular extension or positive margins.
With EORTC 22931, this trial defines who receives postoperative chemoradiation: patients with extranodal extension or positive margins, not those whose only risk factor is multiple nodes.
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 HPV-negative head and neck squamous cell carcinoma (including HPV-negative oropharyngeal cancer), New England Journal of Medicine.
Shares HPV-negative head and neck squamous cell carcinoma (including HPV-negative oropharyngeal cancer), New England Journal of Medicine.
Shares Buccal mucosa and gingivobuccal cancer (oral cancer in India), Oral cavity cancer (mouth and tongue), New England Journal of Medicine.
Shares HPV-negative head and neck squamous cell carcinoma (including HPV-negative oropharyngeal cancer), New England Journal of Medicine.
Shares Buccal mucosa and gingivobuccal cancer (oral cancer in India), Oral cavity cancer (mouth and tongue).
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).
Shares Buccal mucosa and gingivobuccal cancer (oral cancer in India), Oral cavity cancer (mouth and tongue).