Chemotherapy added to locoregional treatment for head and neck squamous-cell carcinoma: three meta-analyses of updated individual data

Pignon, J.P.; Bourhis, Jean; Domenge, C.; Designé, L.

doi:10.1016/s0140-6736(00)90011-4

Cited by 1,868 publications

(271 citation statements)

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“…The chemotherapy effect we observed is consistent with the overall effect of chemotherapy demonstrated by Pignon et al (2000) in their meta-analysis, i.e. a 10% reduction in the risk of death.…”

Section: Discussionsupporting

confidence: 89%

“…The effect of neoadjuvant cisplatin plus fluorouracil on survival in our trial (a hazard ratio for death of 0.71 with a 95% CI of 0.40-1.02) is in agreement with the significant benefit observed with neoadjuvant cisplatin plus fluorouracil (hazard ratio 0.88, 95% CI 0.79-0.97) in the above-mentioned meta-analysis which includes our trial. Pignon et al (2000) found that the effect of a neoadjuvant regimen combining cisplatin and fluorouracil was significantly different (P = 0.05) from that of the other neoadjuvant regimens. These other regimens either did not contain cisplatin or were early studies of suboptimal cisplatin doses.…”

Section: Discussionmentioning

confidence: 86%

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Randomized trial of neoadjuvant chemotherapy in oropharyngeal carcinoma

et al. 2000

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Patients with head and neck cancer represent 11% of the malignant tumours diagnosed in French males (Ménégoz et al, 1998). While most small tumours can be cured, a majority of the tumours are advanced and despite progress in surgery and radiotherapy, the prognosis remains poor. In the past years, systemic chemotherapy has been used in an attempt to improve the results of loco-regional treatment. Clinical trials have shown a high response rate with a combination of Cisplatinum (CDDP) and 5 Fluoro-Uracil (5FU) in head and neck carcinoma sites (Decker et al, 1983;Weaver et al, 1985;Calais et al, 1988).In 1986, we decided to investigate the efficiency of neoadjuvant chemotherapy in a single tumour site: the oropharynx with survival as the main study end-point, and event-free survival as a secondary endpoint. MATERIALS AND METHODSAll patients with a biopsy-proven squamous cell carcinoma of all sites of the oropharynx except for the posterior wall and the anterior surface of epiglottis, classified as T2 to T4, N 0 to N 2b , and M 0 (UICC-AJC, 1986) were eligible if curative treatment, either radiotherapy or surgery, was considered feasible. Patients older than 69, younger than 18 or in whom chemotherapy was contraindicated, or who had previously been treated, or with multiple tumours were excluded. Patients were randomized by telephone to receive either neoadjuvant chemotherapy or no chemotherapy. Randomization was stratified on the centre and on the local treatment which was either surgery followed or not by radiotherapy, or radiotherapy alone.The treatment planned consisted, in the study arm, of 3 chemotherapy cycles followed, if possible, by surgery and systematic radiotherapy, or if surgery was impossible by radiotherapy alone. Post-randomization consent was obtained from each patient in accordance with the law in use in France at the time of the trial.A total of 318 patients treated in 6 centres were included in the trial between 1986 and 1992. ChemotherapyChemotherapy consisted of Cisplatin (100 mg/m 2 ) given in a 1-hour i.v. infusion on day 1 followed by a 24-hour i.v. infusion of fluorouracil (1000 mg/m 2 /day) for 5 days. This treatment was repeated on day 22 unless tumour progression exceeded 25%, and repeated on day 43 only if tumour regression had been observed. 2-3 weeks after the end of chemotherapy, local treatment (surgery and/or radiotherapy) was performed. SurgeryThe operative procedure in both groups consisted of a commando procedure i.e. oropharyngeal composite resection with segmental Summary The objective of the study was to evaluate the effect of neoadjuvant chemotherapy on the survival of patients with oropharyngeal cancer. Patients with a squamous cell carcinoma of the oropharynx for whom curative radiotherapy or surgery was considered feasible were entered in a multicentric randomized trial comparing neoadjuvant chemotherapy followed by loco-regional treatment to the same locoregional treatment without chemotherapy. The loco-regional treatment consisted either of surgery plus radiotherapy or...

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Section: Discussionsupporting

confidence: 89%

Section: Discussionmentioning

confidence: 86%

Randomized trial of neoadjuvant chemotherapy in oropharyngeal carcinoma

et al. 2000

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“…The American Joint Committee on Cancer (AJCC) staging is gen-erally used to estimate the prognosis and guide therapy (Edge and Compton, 2010). Radio-chemotherapy is a standard treatment of unresectable and/or locally advanced Head and Neck Cancers (Pignon et al, 2000;St Guily et al, 2010). Despite this treatment, the prognosis remains worst and loco-regional recurrence may occur in up to 40% patients, mostly within the first 2-years after treatment (Chajon et al, 2013).…”

Section: Introductionmentioning

confidence: 99%

Overview of the predictive value of quantitative 18 FDG PET in head and neck cancer treated with chemoradiotherapy

Castelli

Bari

Depeursinge

et al. 2016

Critical Reviews in Oncology/Hematology

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International audience18 F-fluorodeoxyglucose (18F-FDG) positron emission tomography/computed tomography (PET/CT) allows to quantify the metabolic activity of a tumor (glycolysis) and has become a reference tool in oncology for the staging, restaging, radiotherapy planning and monitoring response in many cancers. Quantitative analyses have been introduced in order to overcome some of the limits of the visual methods, allowing an easier and more objective comparison of the inter- and intra-patients variations. The aims of this review were to report available evidences on the clinical value of quantitative PET/CT parameters in HNC. Forty-five studies, for a total of 2928 patients, were analyzed. Most of the data available dealt with the intensity of the metabolism, calculated from the Standard Uptake Value (SUV). Metabolic Tumor Volume (MTV) was well correlated with overall survival and disease free survival, with a higher predictive value than the maximum SUV. Spatial distribution of metabolism and textural analyses seems promising

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“…These patients tend to present with locally advanced disease and are treated aggressively with some combination of surgery, chemotherapy, and radiotherapy [20]. Intensive chemoRT regimens have been found to be effective in the management of HNC in terms of improving both progression free and overall survival [21]. With aggressive chemoRT treatment, however, come side effects such as dysphagia, or difficulty swallowing, that have a negative impact on a patient's quality of life [22,23].…”

Section: Measuring Dysphagia In Head and Neck Cancer Patientsmentioning

confidence: 99%

A latent variable transformation model approach for exploring dysphagia

Snavely

Harrington

2014

Statistics in Medicine

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Multiple outcomes are often collected in applications where the quantity of interest cannot be measured directly, or is difficult or expensive to measure. For example, in a head and neck cancer study conducted at Dana-Farber Cancer Institute, the investigators wanted to determine the effect of clinical and treatment factors on unobservable dysphagia through collected multiple outcomes, which are of mixed types. Latent variable models are commonly adopted in this setting. These models stipulate that the multiple collected outcomes are conditionally independent given the latent factor. Mixed types of outcomes (e.g. continuous vs ordinal) and censored outcomes present statistical challenges, however, as a natural analog of the multivariate normal distribution does not exist for mixed data. Recently, Lin et al.[1] proposed a semiparametric latent variable transformation model for mixed outcome data, however it may not readily acommodate survival or event time outcomes where censoring is present. In this paper we extend the work of Lin et al. [1] by proposing both semiparametric and parametric latent variable models that allow for the estimation of the latent factor in the presence of measurable outcomes of mixed types, including censored outcomes. Both approaches allow for a direct estimate of the treatment (or other covariate) effect on the unobserved latent variable, greatly enhancing the interpretability of the models. The semiparametric approach has the added advantage of allowing the relationship between the measurable outcomes and latent variables to be unspecified, rendering more robust inference. The parametric and semiparametric models can also be used together, providing a comprehensive modeling strategy for complicated latent variable problems.

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Chemotherapy added to locoregional treatment for head and neck squamous-cell carcinoma: three meta-analyses of updated individual data

Cited by 1,868 publications

References 10 publications

Randomized trial of neoadjuvant chemotherapy in oropharyngeal carcinoma

Randomized trial of neoadjuvant chemotherapy in oropharyngeal carcinoma

Overview of the predictive value of quantitative 18 FDG PET in head and neck cancer treated with chemoradiotherapy

A latent variable transformation model approach for exploring dysphagia

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