Source: www.hemonctoday.com
Author: Christen Haigh

In patients with advanced head and neck cancer, using an accelerated, shorter course of radiation therapy combined with cisplatin allowed a decreased amount of chemotherapy, thus reducing toxicity, according to findings from the phase-3 RTOG 0129 trial presented at the Multidisciplinary Head and Neck Cancer Symposium in Chandler, Ariz.

Researchers analyzed data from patients with stage III to stage IV carcinoma of the oral cavity, oropharynx, hypopharynx or larynx. They assigned 360 patients to accelerated radiation with two cycles of cisplatin and 361 patients to standard radiation with three cycles of cisplatin. The median follow-up was 4.8 years.

“There were no differences in treatment outcome or in acute and long-term toxicity,” Phuc Felix Nguyen-Tan, MD, assistant professor of radiation oncology at CHUM Notre-Dame in Montreal, Canada, said during a news briefing.

OS was similar between treatment groups: 59% for the accelerated radiation group and 56% for the standard radiation group (HR=0.9; 95% CI, 0.72-1.13). DFS rates were 45% for patients assigned to accelerated radiation and 44% for patients assigned to standard radiation (P=.42).

Local-regional failure rates were 31% with accelerated radiation and 28% with standard radiation (P=.76). Metastasis rates were also similar with rates of 18% with accelerated treatment and 22% percent with standard treatment (P=.06).

There were no major differences between groups for grade-3 to grade-4 acute mucositis and worst grade-3 to grade-4 late toxicity: The acute mucositis rate was 33% with accelerated radiation and 40% with standard radiation, and the late toxicity rate was 26% with accelerated therapy and 21% with standard therapy.

“Accelerated fractionation concurrent with two doses of high-dose cisplatin has the potential to reduce toxicity related to the chemotherapy regimen by not exposing patients to a third cycle,” Nguyen-Tan, said in a press release.