Concomitant chemoradiotherapy versus acceleration of radiotherapy with or without concomitant chemotherapy in locally advanced head and neck carcinoma (GORTEC 99-02): an open-label phase 3 randomised trial

Bourhis, Jean; Siré, C.; Gräff, P.; Grégoire, Vincent; Maingon, P.; Calais, G.; Géry, B.; Martin, Laurent; Alfonsi, M.; Desprez, P.; Pignon, T.; Bardet, É.; Rives, M.; Geoffrois, L.; Daly-Schveitzer, N.; Sen, Sok; Tuchais, C.; Dupuis, Olivier; Guérif, S.; Lapeyre, M.; Favrel, V.; Hamoir, Marc; Lusinchi, A.; Temam, Stéphane; Pinna, Antonella; Tao, Yungan; Blanchard, Pierre; Aupérin, Anne

doi:10.1016/s1470-2045(11)70346-1

Cited by 323 publications

(244 citation statements)

References 24 publications

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“…Furthermore, the meta-analysis by Bourhis et al (2012) underlined the importance of increasing total RT-dose in order to improve LC and OS, but comparing different schedules with or without CT could introduce additional confounding variables.…”

Section: Discussionmentioning

confidence: 99%

“…Eleven randomized trials (Forastiere et al, 2013;Bourhis et al, 2012;Calais et al, 1998;Ang et al, 2010;Staar et al, 2001;Jeremic et al, 1997Jeremic et al, , 2004Huguenin et al, 2004;Brizel et al, 1998;Budach et al, 2005) were identified reporting four clinical endpoints. Nine trials (2785 patients) were used to extract model parameters for mixed LA-HNSCC cohort.…”

Section: Data Preparationmentioning

confidence: 99%

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Efficacy and mucosal toxicity of concomitant chemo-radiotherapy in patients with locally-advanced squamous cell carcinoma of the head-and-neck in the light of a novel mathematical model

Strigari

Pinnarò²,

Carlini³

et al. 2016

Critical Reviews in Oncology/Hematology

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Background: In the last several decades, combined radiotherapy (RT) and chemotherapy (CT) have beenrecognized as feasible in locally-advanced-squamous-cell-carcinoma of the head-and-neck (LA-HNSCC).Several meta-analyses identified concurrent RT + CT (CRT) most likely effective approach respect toRT-alone. However, radiobiological models comparing different chemotherapeutic schedules againstdelivered RT fractionation schedule for overall survival and toxicity are still needed.Methods and materials: Based on 9 randomized trials (2785 patients), radiobiological models andmultivariate logistic regression model were used to derive dose-response curves and estimate the 5-year-overall survival (OS) and ≥G3 acute mucositis rate of CRT or RT-alone.Results: Equivalent dose at 2 Gy/fraction (EQD2) was calculated using the linear quadratic model. Theeffect of CRT schedules, considering the CT type and its administration schedule and the HPV status oftumors were estimated using the univariate/multivariate logistic regression. The multivariate logisticregression model for 5y-OS indicated EQD2 and the type of CT, the chemo-sensitization fraction and theHPV status significant prognostic factors, while for toxicity both EQD2 and the concomitant adminis-tration of 5-fluorouracil (5Fu) resulted as significant prognostic factors. Combined schedules cisplatin(DDP)+/−5Fu + RT produced the higher OS compared with combined carboplatin+/−5Fu + RT or RT-alone

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Section: Discussionmentioning

confidence: 99%

Section: Data Preparationmentioning

confidence: 99%

Efficacy and mucosal toxicity of concomitant chemo-radiotherapy in patients with locally-advanced squamous cell carcinoma of the head-and-neck in the light of a novel mathematical model

Strigari

Pinnarò²,

Carlini³

et al. 2016

Critical Reviews in Oncology/Hematology

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“…A total dose of 70 Gy 2 Gy/fraction/day, 35 fractions (Rennes) or 2.12Gy/fractions/day, 33 fractions (Lausanne) with a simultaneous integrated boost technique [18] was given in combination to concomitant chemotherapy [5,6] or cetuximab [7] if the patients were not fit for chemotherapy. The modality of planning and treatment were the same as previously published [19].…”

Section: Treatment and Planningmentioning

confidence: 99%

A PET-based nomogram for oropharyngeal cancers

Castelli

Depeursinge

Ndoh

et al. 2017

European Journal of Cancer

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Purpose: In the context of locally advanced oropharyngeal cancer (LAOC) treated with definitive radiotherapy (RT) (combined with chemotherapy or cetuximab), the aims of this study were: (1) to identify PET-FDG parameters correlated with overall survival (OS) from a first cohort of patients; then (2) to compute a prognostic score; and (3) finally to validate this scoring system in a second independent cohort of patients. Materials and methods: A total of 76 consecutive patients (training cohort from Rennes) treated with chemoradiotherapy or RT with cetuximab for LAOC were used to build a predictive model of locoregional control (LRC) and OS based on PET-FDG parameters. After internal calibration and validation of this model, a nomogram and a scoring system were developed and tested in a validation cohort of 46 consecutive patients treated with definitive RT for LAOC in Lausanne. Results: In multivariate analysis, the metabolic tumour volume (MTV) of the primary tumour and the lymph nodes were independent predictive factors for LRC and OS. Internal calibration showed a very good adjustment between the predicted OS and the observed OS at 24 months. Using the predictive score, two risk groups were identified (median OS 42 versus 14 months, p < 0.001) and confirmed in the validation cohort from Lausanne (median OS not reached versus 26 months, p Z 0.008). Conclusions: This is the first report of a PET-based nomogram in oropharyngeal cancer. Interestingly, it appeared stronger than the classical prognostic factors and was validated in independent cohorts markedly diverging in many aspects, which suggest that the observed signal was robust. ª

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“…Despite known survival benefits of treating locoregionally advanced HNSCC with either concurrent chemoradiotherapy or altered fractionated radiotherapy regimens over standard radiotherapy fractionation alone [2][3][4], efforts to further intensify therapy by the addition of chemotherapy to accelerated radiotherapy plans have failed to improve on clinical outcomes over conventional chemoradiotherapy in recently published randomized phase III trials (RTOG 0129 and GORTEC 99-02) [5,6]. With hopes to further improve outcomes, the Radiation Therapy Oncology Group (RTOG) is currently using mildly accelerated radiation (6 fractions per week as in the DAHANCA 6 & 7 trial [7] and the IAEA-ACC trial [8]) with concurrent chemotherapy as the standard arm in its trials.…”

Section: Systemic Therapy Should Not Be Administered Concurrently Witmentioning

confidence: 99%

When is chemotherapy in head and neck squamous cell carcinoma not indicated?

Haigentz

Vermorken

Forastiere

et al. 2014

Eur Arch Otorhinolaryngol

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Concomitant chemoradiotherapy versus acceleration of radiotherapy with or without concomitant chemotherapy in locally advanced head and neck carcinoma (GORTEC 99-02): an open-label phase 3 randomised trial

Cited by 323 publications

References 24 publications

Efficacy and mucosal toxicity of concomitant chemo-radiotherapy in patients with locally-advanced squamous cell carcinoma of the head-and-neck in the light of a novel mathematical model

Efficacy and mucosal toxicity of concomitant chemo-radiotherapy in patients with locally-advanced squamous cell carcinoma of the head-and-neck in the light of a novel mathematical model

A PET-based nomogram for oropharyngeal cancers

When is chemotherapy in head and neck squamous cell carcinoma not indicated?

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