• 11/16/2004
  • Laura McMahon
  • Medical News Today

The addition of neoadjuvant chemotherapy to concurrent chemoradiation may be a promising approach for treating patients with inoperable advanced head and neck cancer, according the authors of a 10-year follow-up of a randomized trial.

In 1986, a randomized phase III trial began in which 237 patients with nonmetastatic stage III or IV head and neck squamous cell carcinoma were treated with either four cycles of neoadjuvant chemotherapy followed by locoregional treatment (surgery and radiotherapy or radiotherapy alone) or locoregional treatment alone. Two years after treatment began, there was no difference in survival between the two groups.

In a follow-up at 5 and 10 years after treatment, Adriano Paccagnella, M.D., of SS Giovanni and Paolo Hospital in Venice, and colleagues report again that there was no difference in survival between the two groups. However, among patients who did not receive surgery because their tumors were inoperable, those who received neoadjuvant chemotherapy had a higher rate of survival than patients who did not receive chemotherapy.

In an editorial, Arlene A. Forastiere, M.D., of the Johns Hopkins Kimmel Cancer Center in Baltimore, notes that these promising follow-up results bolster soon-to-be activated trials of chemoradiotherapy–the current standard of treatment for advanced head and neck cancer–with and without neoadjuvant chemotherapy.