| No advantage gained from adding chemotherapy to post-surgical radiation for patients with advanced head and neck cancers There is no advantage to adding chemotherapy to post-surgical radiation for cases of advanced head and neck cancer, according to preliminary research findings presented at the American Society of Clinical Oncology meeting. Recurrence and metastasis of head and neck cancer is common; Fewer than 50 percent of these patients are expected to survive beyond 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., of the Johns Hopkins Kimmel Cancer Center. "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 and were at high risk for recurrence. After surgery, patients in one group received radiation alone whereas the second received 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 side effects, such as lower blood counts, nausea and mouth soreness, than those receiving radiation alone. Three patients (two percent of the total evaluated) receiving combination therapy died during the study. There were no deaths during the study in the radiation-only group. "The fact that many of these patients receiving combination therapy could not handle all of the chemotherapy suggests that we should look in another direction," explains Forastiere. "Adding targeted drugs and those with less side effects may be a better alternative." For now, researchers say that the standard treatment for advanced head and neck cancer patients who have had surgery will remain radiation therapy alone. The researchers studied head and neck cancers located in the larynx or pharynx. These cancers are diagnosed in approximately 37,800 patients every year, and about 11,100 Americans will die from the disease. |