Addition of Chemotherapy to Radiation Improves Long-Term Survival

Addition of Chemotherapy to Radiation Improves Long-Term Survival in Patients with Oropharyngeal Cancer

According to results recently published in the Journal of Clinical Oncology, long-term results indicate that the addition of chemotherapy to radiation therapy improves survival in patients with advanced oropharyngeal cancer.

Oropharyngeal cancer is considered a type of head and neck cancer. Oropharyngeal cancer refers to cancer of the mouth and top of the throat. Advanced oropharyngeal cancer refers to cancer that has spread from its site of origin to distant sites in the body. Standard treatment approaches may include surgery, radiation therapy and/or chemotherapy. Researchers have been evaluating the optimal treatment regimen or treatment combinations to improve survival and/or quality of life for patients with advanced oropharyngeal cancer.

Researchers from France recently reported long-term results from a clinical trial directly comparing chemotherapy plus radiation therapy to radiation therapy alone in the treatment of advanced oropharyngeal cancer. The chemotherapy regimen utilized was carboplatin (Paraplatin®) and 5-FU (fluorouracil). Patients were treated with either the combination of chemotherapy plus radiation, or radiation alone, and outcomes were directly compared. Five years following treatment, overall survival was improved to 22% in patients treated with the combination of chemotherapy and radiation, compared to 16% for those treated with radiation alone. The mortality rate caused from cancer was 73% for patients treated with chemotherapy/radiation, compared with 85% for those treated with radiation alone. Cancer that did not recur at or near the site of origin was achieved in nearly 50% of patients treated with combination therapy, compared with only 25% of patients treated with radiation therapy alone. Upon analyses of several variables, the presence of anemia (low levels of red blood cells) and being treated with radiation only were the greatest predictors for poor survival. Late side effects were similar between the two groups of patients.

The researchers concluded that the addition of chemotherapy to radiation therapy appears to significantly improve survival in patients with advanced oropharyngeal cancer. However, the overall rate of survival remains suboptimal and novel therapeutic regimens are necessary. Patients with advanced oropharyngeal cancer may wish to speak with their physician about the risks and benefits of participating in a clinical trial evaluating different chemotherapy combinations or novel therapeutic approaches for the treatment of their cancer.

Reference: Denis F, Garaud P, Bardet E, et al. Final results of the 94-01 French Head and Neck Oncology and Radiotherapy Group Randomized Trial Comparing Radiotherapy Alone with Concomitant Radiochemotherapy in Advanced-Stage Oropharynx Cancer.

Journal of Clinical Oncology. 2003;22:69-76.

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