Abstract
Background
Multimodality treatments involving radical surgery followed by high-dose cisplatin-sensitized chemoradiotherapy (SCCRT) now are standard of care for Stages III and IV SCCHN, with 5-year survival remaining 25-50%. Simultaneous fractionated cisplatin and radiation therapy (CTRT) is promising. Objective: to review SCCHN treatment history while evaluating parallel CTRT development.
Methods
The history of surgical, radiotherapy (RT), chemotherapy, immunotherapy, and multimodal SCCHN was reviewed. 187 Stages III/IV SCCHN CTRT patients (cisplatin 20 mg/M
2
IV 4 consecutive days weeks 1, 4, of 7000-7400 cGy (RT)) were examined. CTRT results: CCR = Clinical Complete Response–no clinical tumor. PCR = Partial Clinical Response–clinical residual tumor. HCR = Histologic Complete Response–tumor-free biopsy of primary site. Statistics: Chi-squared, ANOVA, and Kaplan-Meier.
Results
Fifty years of evolution in SCCHN Stage III/IV treatment identified curative surgery plus combined high-dose cisplatin/radiotherapy as standard of care, with 5-year survival
Discussion
Advances have improved SCCHN local control, but survival remains sub-optimal. CTRT might be an alternative to surgery plus high-dose cisplatin chemoradiotherapy, potentially increasing organ preservation and survival with reduced operative morbidity and toxicity.