TITLE:
Stage III and IV Head and Neck Cancer: Does Everyone Need Chemotherapy?
AUTHORS:
Gaurav Marwaha, William L. Barrett
KEYWORDS:
Head and Neck Cancer; Concurrent Chemoradiation; Definitive Radiation
JOURNAL NAME:
International Journal of Otolaryngology and Head & Neck Surgery,
Vol.3 No.1,
January
9,
2014
ABSTRACT: Objectives: Definitive treatment of Stage III and IV
squamous cell carcinoma can be with surgical resection, definitive radiation
therapy alone or combined radiation therapy with chemotherapy. Radiation and
concomitant platinum-based chemotherapy are the accepted gold standard. The purpose of this study was to
determine how often patients treated with radiation therapy alone developed
locoregionally recurrent disease that in retrospect possibly could have been
prevented with the addition
of chemotherapy. Methods: 116 consecutive patients with known Stage III
and Stage IV head and neck cancers were treated with curative intent with
radiation therapy alone. Results of the treatment were retrospectively
reviewed. Results: Of the
116 patients treated with radiation alone, 11 (9.48%) died from locally
recurrent disease, 6 (5.17%) died from local disease and were never disease-free, 7 (6.03%) died from metastatic disease,
9 (7.75%) died from disease NOS, 6 (5.17%) died from secondary malignancy, 10
(8.62%) died from ICD (2 oropharynx; 8 larynx), 6 (5.17%) died from uncertain
causes, 51 (43.96%) are alive and disease-free, and 10 (8.62%) patients’ final
outcome data were not
recoverable. Conclusions: Cure rates in selected patients with advanced
head and neck cancer may be similar with radiation alone compared to radiation
with the addition of chemotherapy.