title: Preoperative simultaneous fractionated cisplatin and radiation therapy in the treatment of advanced operable stage III and IV squamous cell carcinoma of the head and neck.
abstract: BACKGROUND
  In Stage III/IV head and neck squamous cell carcinoma of the head and neck, multidisciplinary treatment is not standardized. This study evaluated preoperative simultaneous radiation therapy and Cisplatin 20 mg/M(2)/4 days during weeks 1, 4, and 7 of irradiation (CTRT).
  
  
  METHODS
  Records of 143 CTRT and 48 patients treated with other surgery/radiation/chemotherapy regimens (CONTROL) were reviewed. Chi-square, analysis of variance, and Kaplan-Meier statistical analysis were performed.
  
  
  RESULTS
  CTRT improved outcomes in Grade 2 to 5 toxicity (76% CONTROL vs 45% CTRT, P < .0001), complete clinical response (68% CTRT vs 36% CONTROL, P < .003), histologic complete response (67% in CTRT vs 28% in CONTROL, P = .0002), recurrence (33% in CTRT vs 66% in CONTROL, P = .0007), and distant metastases (2% CTRT vs 37% CONTROL, P = .0003); Kaplan-Meier disease-free survival was 65% CTRT versus 34% CONTROL.
  
  
  CONCLUSIONS
  CTRT increases complete clinical response, histologic complete response, organ preservation, and survival, with lower recurrence and reduced toxicity and rare recurrence. CTRT may be the first treatment for Stage III/IV head and neck squamous cell carcinoma of the head and neck.
authors.affiliation: Inspira Health Network, Vineland, NJ, USA.
authors.forename: Michael A
authors.initials: MA
authors.lastname: Davis
authors.affiliation: Inspira Health Network, Vineland, NJ, USA.
authors.forename: Jessica
authors.initials: J
authors.lastname: Tyrrell
authors.affiliation: Inspira Health Network, Vineland, NJ, USA. Electronic address: slotmang@ihn.org.
authors.forename: Gus J
authors.initials: GJ
authors.lastname: Slotman
authors.affiliation: Inspira Health Network, Vineland, NJ, USA.
authors.forename: Rama
authors.initials: R
authors.lastname: Sudhindra
authors.affiliation: Inspira Health Network, Vineland, NJ, USA.
authors.forename: Kush
authors.initials: K
authors.lastname: Sachdeva
authors.affiliation: Inspira Health Network, Vineland, NJ, USA.
authors.forename: Joseph
authors.initials: J
authors.lastname: Fanelle
authors.affiliation: Inspira Health Network, Vineland, NJ, USA.
authors.forename: Glenda
authors.initials: G
authors.lastname: Smith
authors.affiliation: Inspira Health Network, Vineland, NJ, USA.
authors.forename: James V
authors.initials: JV
authors.lastname: Wurzer
authors.affiliation: Inspira Health Network, Vineland, NJ, USA.
authors.forename: Jorge
authors.initials: J
authors.lastname: Cassir
authors.affiliation: Inspira Health Network, Vineland, NJ, USA.
authors.forename: Naim T
authors.initials: NT
authors.lastname: Nazha
mesh_terms: D000284:Administration, Oral; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000970:Antineoplastic Agents / Q000008:administration & dosage; D002294:Carcinoma, Squamous Cell / Q000175:diagnosis / Q000401:mortality / Q000628:therapy*; D059186:Chemoradiotherapy, Adjuvant; D002945:Cisplatin / Q000008:administration & dosage*; D018572:Disease-Free Survival; D019583:Dose Fractionation, Radiation; D004305:Dose-Response Relationship, Drug; D005260:Female; D005500:Follow-Up Studies; D006258:Head and Neck Neoplasms / Q000175:diagnosis / Q000401:mortality / Q000628:therapy*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D009515:New Jersey / Q000453:epidemiology; D012189:Retrospective Studies; D000077195:Squamous Cell Carcinoma of Head and Neck; D015996:Survival Rate / Q000639:trends; D016896:Treatment Outcome
chemical_list: D000970:Antineoplastic Agents; D002945:Cisplatin
keywords: Cisplatin; Head and neck cancer; Radiation therapy; Squamous cell carcinoma