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 |
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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 |
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ISSN: | 0167-8140 1879-0887 |
DOI: | 10.1016/j.radonc.2020.05.021 |