Concurrent cisplatin and dose escalation with intensity-modulated radiotherapy (IMRT) versus conventional radiotherapy for locally advanced head and neck squamous cell carcinomas (HNSCC): GORTEC 2004-01 randomized phase III trial

•Xerostomia was markedly decreased with IMRT vs 3D in LA-HNSCC in a phase 3 trial.•This dose-escalation with IMRT (75 Gy) was well tolerated with high dose cisplatin.•Dose-escalated IMRT did not improve tumor control over standard 3D-RT in HNSCC. Concurrent chemoradiotherapy (CRT) is the standard of...

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Veröffentlicht in:Radiotherapy and oncology 2020-09, Vol.150, p.18-25
Hauptverfasser: Tao, Yungan, Auperin, Anne, Blanchard, Pierre, Alfonsi, Marc, Sun, Xu-Shan, Rives, Michel, Pointreau, Yoann, Castelli, Joël, Graff, Pierre, Wong Hee Kam, Stéphanie, Thariat, Juliette, Veresezan, Ovidiu, Heymann, Steve, Renard-Oldrini, Sophie, Lafond, Cédrik, Cornely, Alexandre, Casiraghi, Odile, Boisselier, Pierre, Lapeyre, Michel, Biau, Julian, Bourhis, Jean
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Sprache:eng
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Zusammenfassung:•Xerostomia was markedly decreased with IMRT vs 3D in LA-HNSCC in a phase 3 trial.•This dose-escalation with IMRT (75 Gy) was well tolerated with high dose cisplatin.•Dose-escalated IMRT did not improve tumor control over standard 3D-RT in HNSCC. Concurrent chemoradiotherapy (CRT) is the standard of care (SoC) in locally advanced (LA) head and neck squamous cell carcinomas (HNSCC). This trial was designed to test whether dose-escalated IMRT and cisplatin could improve locoregional control without increasing complications over 3D-radiotherapy. Patients were randomized between 70 Gy/35F in 7 weeks with 3D-RT (Arm A) versus 75 Gy/35F with IMRT (Arm B). Both arms received 50 Gy in 25 fractions followed by a sequential boost of 20 Gy/10F in Arm A and 25 Gy/10F to gross tumor volume in Arm B, as well as 3 cycles of cisplatin at 100 mg/m2 during RT. The primary endpoint was locoregional progression (LRP). 188 patients were randomized: 85% oropharynx and 73% stage IVa. P16 status was documented for 137 oropharyngeal tumors with P16+ in 53 (39%) patients; and 90% were smokers. Median follow-up was 60.5 months. Xerostomia was markedly decreased in arm B (p 
ISSN:0167-8140
1879-0887
DOI:10.1016/j.radonc.2020.05.021