• Head & neck · Nov 2015

    Randomized Controlled Trial Multicenter Study Comparative Study

    Randomized phase III study of 2 cisplatin-based chemoradiation regimens in locally advanced head and neck squamous cell carcinoma: impact of changing disease epidemiology on contemporary trial design.

    • Cristina P Rodriguez, David J Adelstein, Lisa A Rybicki, Panayiotis Savvides, Jerrold P Saxton, Shlomo A Koyfman, John F Greskovich, Min Yao, Joseph Scharpf, Pierre Lavertu, Benjamin G Wood, Brian B Burkey... more , Robert R Lorenz, Rod P Rezaee, Chad A Zender, and Denise I Ives. less
    • University of Washington, Seattle Cancer Care Alliance, Seattle, Washington.
    • Head Neck. 2015 Nov 1; 37 (11): 1583-9.

    BackgroundChemoradiotherapy results in excellent outcomes in locally advanced head and neck squamous cell carcinoma (HNSCC). This trial compared 2 chemoradiotherapy regimens.MethodsPatients with locally advanced HNSCC were treated with radiation (70-74.4 Gy), and randomized to arm A: cisplatin 100 mg/m(2) on radiotherapy (RT) days 1, 22, and 43, or arm B: cisplatin (20 mg/m(2) /day) and 5-fluorouracil (5-FU; 1000 mg/m(2) /day) continuous 96-hour infusions on RT weeks 1 and 4. The primary endpoint was relapse-free survival (RFS).ResultsBetween February 2008 and October 2011, 69 patients were enrolled in this study. The study prematurely closed when a scheduled interim analysis showed superior outcomes in both arms and futility of continuation. Eighty-three percent of patients had oropharyngeal cancer, of these, 86% were human papillomavirus (HPV)/p16+. The 3-year Kaplan-Meier outcome estimates (median follow-up, 41 months) for arms A and B were: RFS 87% versus 80% (p = .24), overall survival 97% versus 85% (p = .013), locoregional control 96% versus 94% (p = .52), and distant metastatic control 91% versus 87% (p = .9).ConclusionMultiagent was not superior to single-agent chemoradiotherapy. Overrepresentation of HPV/p16+ patients resulted in better than expected outcomes.© 2014 Wiley Periodicals, Inc.

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