BACKGROUND: This systematic review evaluates the use of postoperative chemoradiotherapy for patients with advanced (stage III or IV) squamous cell carcinoma of the head and neck at a high risk of recurrence. METHODS: The literature was systematically searched for eligible randomized controlled trials (RCTs). RESULTS: Of 4 RCTs identified, 3 reported improvements in locoregional control, 3 reported improved disease-free or progression-free survival, and 3 reported improved overall survival with chemoradiotherapy compared with radiotherapy alone. Pooling trials confirmed the benefit for chemoradiotherapy in locoregional recurrence (relative risk [RR] = 0.59; 95% confidence interval [CI] = 0.47-0.75; p < .00001) and overall survival (RR = 0.80; 95% CI = 0.71-0.90; p = .0002). More frequent and severe acute mucosal toxicity was reported with combined treatment. CONCLUSIONS: Postoperative adjuvant chemoradiotherapy is superior to radiotherapy alone. Because chemoradiotherapy is associated with significantly increased toxicity, further investigations to identify patients most likely to benefit or toxicity reduction strategies are warranted.
BACKGROUND: This systematic review evaluates the use of postoperative chemoradiotherapy for patients with advanced (stage III or IV) squamous cell carcinoma of the head and neck at a high risk of recurrence. METHODS: The literature was systematically searched for eligible randomized controlled trials (RCTs). RESULTS: Of 4 RCTs identified, 3 reported improvements in locoregional control, 3 reported improved disease-free or progression-free survival, and 3 reported improved overall survival with chemoradiotherapy compared with radiotherapy alone. Pooling trials confirmed the benefit for chemoradiotherapy in locoregional recurrence (relative risk [RR] = 0.59; 95% confidence interval [CI] = 0.47-0.75; p < .00001) and overall survival (RR = 0.80; 95% CI = 0.71-0.90; p = .0002). More frequent and severe acute mucosal toxicity was reported with combined treatment. CONCLUSIONS: Postoperative adjuvant chemoradiotherapy is superior to radiotherapy alone. Because chemoradiotherapy is associated with significantly increased toxicity, further investigations to identify patients most likely to benefit or toxicity reduction strategies are warranted.
Authors: Lance C Pagliaro; Dallas L Williams; Danai Daliani; Michael B Williams; William Osai; Michael Kincaid; Sijin Wen; Peter F Thall; Curtis A Pettaway Journal: J Clin Oncol Date: 2010-07-12 Impact factor: 44.544
Authors: Ifigenia Vasiliadou; David Noble; Andrew Hartley; Rafael Moleron; Paul Sanghera; Teresa Guerrero Urbano; Stefano Schipani; Dorothy Gujral; Bernie Foran; Shree Bhide; Anoop Haridass; Kannon Nathan; Andriana Michaelidou; Mehmet Sen; Konstantinos Geropantas; Mano Joseph; Lorcan O'Toole; Matthew Griffin; Laura Pettit; Jonathan Chambers; Petra Jankowska; Emma De Winton; Rebecca Goranova; Niveditha Singh; Ketan Shah; Anthony Kong Conceptualisation Journal: Clin Transl Radiat Oncol Date: 2021-06-30