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Radiation alone after surgery still the standard for head and neck cancer

A preliminary study has found no advantage to adding chemotherapy to radiation after surgery for treating advanced head and neck cancer patients. The findings of the research, to be presented at the American Society of Clinical Oncology meeting May 18, appear to set aside earlier data suggesting that a combination of chemotherapy and radiation would improve the odds of staying cancer-free after surgery. Results are published in abstract # 903 in the ASCO Program/Proceedings.

Recurrence and spread of head and neck cancer is common and fewer than half of these patients are expected to survive past five years. "Early studies suggested that combining certain chemotherapy drugs and radiation may have a synergistic effect in these patients," says Arlene Forastiere, M.D., professor of oncology and otolaryngology at the Johns Hopkins Kimmel Cancer Center and medical oncology co-chair of the study. "Our current study shows that adding the chemotherapy drug cisplatin to standard radiation treatment does not significantly reduce recurrence."

The study evaluated 407 patients who had surgery to remove their cancer and were at high risk for recurrence. After surgery, patients in one group received radiation alone and, in a second group, a combination of cisplatin and radiation.

In a preliminary analysis after two years, researchers found no significant difference between the two groups in the percentage of patients remaining cancer-free. The cancer recurred in 26 percent of patients receiving radiation alone and in 20 percent of those receiving chemotherapy and radiation. There also was no significant difference between the two groups in overall survival 63 percent in the combination therapy group versus 57 percent who received radiation only.

Just over half (58 percent) of the patients getting combination therapy were able to take all three doses of chemotherapy. The others did not tolerate the full dose. These patients experienced more s
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Contact: Vanessa Wasta
wastava@jhmi.edu
410-955-1287
Johns Hopkins Medical Institutions
18-May-2002


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