Postoperative Irradiation with or without Concomitant Chemotherapy for Locally Advanced Head and Neck Cancer

This randomized trial of adjuvant treatment for locally advanced cancer of the head and neck compared radiotherapy alone with radiotherapy plus concomitant cisplatin after surgery with curative intent. Progression-free and overall survival were superior in the combined-therapy group. Radiotherapy with cisplatin is a promising adjuvant treatment for locally advanced cancer. Local or regional recurrences and distant metastases are frequent after surgical treatment of stage III or IV squamous-cell carcinoma of the head and neck. The risk of failure is particularly high in patients with inadequate resection margins, extranodal spread, or multiple involved lymph nodes. 1 – 4 In patients with such locally advanced tumors, surgery is usually followed by adjuvant radiotherapy. The advantage of postoperative radiotherapy is well documented 2 – 5 and compares favorably with the benefit afforded by preoperative irradiation. 6 , 7 Several studies have demonstrated that concurrent treatment with radiotherapy and chemotherapy is a promising approach for locally advanced squamous-cell carcinoma that . . .