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Title Comparison of 2 chemotherapy regimens in combination with radiotherapy for locally advanced head and neck cancer.
Keywords radiotherapy chemotherapy Head and neck cancer
Researchers prof.dr. J.A. Langendijk
dr. S.F. Oosting
Nature of the research : This is a retrospective comparison of patients with locally advanced head and neck cancer (HNC) who received curative chemoradiotherapy at the University Medical Center Groningen (UMCG) and at the Free University Medical Center (VUmc) in Amsterdam.
Fields of study oncology
Background / introduction
Addition of chemotherapy to radiotherapy for locally advanced HNC improves 5-year overall survival with 6.5% [1]. Most studies have been done with 3-weekly high dose cisplatin, which is considered standard of care. However, this regimen causes significant acute and long-term side effects. Three-weekly carboplatin and 5-fluorouracil is used as an alternative, assuming that efficacy is similar and toxicity is less. However, these regimens have not been compared prospectively head to head. Since 2007, carboplatin plus 5-FU has been the treatment of choice at the UMCG while patients in the VUmc were treated with cisplatin. At both institutes patients have been followed after treatment according to a standard follow-up program for tumor recurrence, acute and long-term toxicity and quality of life. Therefore, comparison of the 2 patient cohorts offers a unique opportunity to study differences in efficacy, toxicity and quality of life of the 2 chemoradiotherapy regimens.
Research question / problem definition
1. Does carboplatin / 5-fluorouracil plus radiotherapy result in similar overall survival compared to cisplatin plus radiotherapy in patients with locally advanced HNC?
2. Does carboplatin / 5-fluorouracil plus radiotherapy result in a similar locoregional control compared to cisplatin plus radiotherapy in patients with locally advanced HNC?
3. Does carboplatin / 5-fluorouracil plus radiotherapy cause less toxicity (tube feeding dependence, infections, renal toxicity, cardiovascular complications) compared to cisplatin plus radiotherapy in patients with locally advanced HNC?
Workplan
1. Combine data from UMCG and VUmc in one data base. Most of the data from UMCG are available in an existing database.
2. Perform statistical comparative analysis on survival, locoregional disease control, toxicity and quality of life
References
1. Pignon JP le Maître A, Maillard E, et al. Meta-analysis of chemotherapy in head and neck cancer (MACH-NC): an update on 93 randomised trials and 17,346 patients. Radiother Oncol 2009;92:4014.
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