HPV and on HPV oral cancers need to be treated differently to reduce toxicity and improve out comes in each type

The National Cancer Institute In a large randomized European clinical trial, accelerated radiation therapy for locally advanced, inoperable head and neck cancer—given either with or without chemotherapy—did not prolong the time to disease progression compared with standard radiation therapy plus concurrent chemotherapy, which has been the standard of care in Europe and the United States. Results from the study were published online January 18 in Lancet Oncology. Another trial published in 2010, by the U.S. Radiation Therapy Oncology Group (RTOG), showed similar results, but the two research teams have drawn different conclusions, which will affect ongoing clinical trials and, potentially, future research collaborations. The researchers, from the European Groupe d'Oncologie Radiothérapie Tête et Cou (GORTEC), compared two experimental regimens with standard chemoradiotherapy in the trial, called GORTEC 99-02. All participating patients had stage III or stage IV head and neck squamous-cell carcinoma that had not metastasized but that could not be removed surgically. The 244 patients in the conventional chemoradiotherapy arm received three cycles of chemotherapy with the drugs carboplatin and fluorouracil plus 70 Gy of radiation given over the standard 7 weeks. In one experimental arm, 245 patients received "accelerated chemoradiotherapy," which consisted of two cycles of the same chemotherapy drugs plus radiation therapy accelerated by 1 week. In the second experimental arm, 242 patients received only "very accelerated" radiation therapy, which consisted of a total dose of 64.8 Gy given over 3.5 weeks. The GORTEC trial results are somewhat difficult to interpret because the trial "didn't change just one variable, it changed two—in addition to the radiation regimen, it also changed the chemotherapy," explained Dr. Bhadrasain [...]