The latest Radiation Therapy Oncology Group (RTOG 9501/Phase III) seems to be a step closer to sorting out just when and who chemo really helps in the treatment of squamous cell cancer of the head and neck.
There are several tumor characteristics that we consider “high risk” for recurrence in head and neck cancer. To date our recommendation has been for generous chemotherapy in addition to radiation therapy for all of these “high risk” groups. However, this study shows that only a subset of these “high risk” patients are really benefited by the addition of chemotherapy. The group having multiply-affected lymph nodes is the group that showed no benefit from the addition of chemotherapy.
The reason the issue is important is because of the added harm and complications that chemo contributes can add up to unnecessarily worsened outcomes, and at times patients not able to tolerate completing their therapy.
This study followed over 400 patients for 10 years after they received full surgical intervention for their cancer (this study did not report patients getting radiation and chemo up front in place of surgery).
Squamous Cell Subgroups Respond Differently to Treatment.