Adding Chemo Helps Head, Neck Cancer Patients
TUESDAY Oct. 27, 2009 -- Combining chemotherapy with radiation treatment for patients with advanced head and neck cancer increases their event-free survival to 2.2 years from just one year with radiotherapy alone, finds a new study.
According to the study authors, "events" include cancer recurrence, new tumors or death.
British researchers looked at the 10-year outcomes of 966 patients with locally advanced head and neck cancer. Those who hadn't undergone surgery for their cancer were randomly assigned to one of four groups: radiotherapy alone (233 patients); two courses of simultaneous (SIM) chemotherapy given at the same time as radiotherapy (166 patients); two courses of chemotherapy after (subsequent -- SUB) completing radiotherapy (160 patients); or both SIM and SUB (154 patients). Patients who'd had surgery were randomly assigned to radiotherapy alone (135 patients) or SIM alone (118 patients).
Overall, non-platinum-based chemotherapy given at the same time as radiotherapy reduced deaths and cancer recurrence in patients who hadn't undergone surgery, with acceptable toxicity. But patients who'd undergone surgery didn't benefit from this combined treatment. The researchers also found that chemotherapy given after radiotherapy was ineffective, didn't improve survival, and doubled the rate of toxicity.
Among patients who didn't have surgery, median survival time was 2.6 years in the radiotherapy group, and 4.7 years, 2.3 years and 2.7 years, respectively, in patients who received SIM alone, SUB alone, and SIM plus SUB.
Median event-free survival among patients who didn't have surgery was one year in the radiotherapy group, 2.2 years in patients who received SIM alone, and one year in those who received either SUB alone, or SIM plus SUB.
The findings show the long-term benefit of non-platinum chemotherapy drugs, which are "inexpensive, relatively easy to deliver, and have lower toxicity than platinum therapies ... [which] considerably improves the likelihood of completing treatment, essential for improving the chances of a cure," wrote the U.K. Head and Neck Cancer Group researchers in their report published in the Oct. 27 online edition of The Lancet Oncology.
Combination chemotherapy/radiation treatment should be standard for all advanced head and neck cancer patients for whom surgery isn't appropriate, they concluded.
The U.S. National Cancer Institute has more about head and neck cancer.
Posted: October 2009