Defining risk levels in locally advanced head and neck cancers: A comparative analysis of concurrent postoperative radiation plus chemotherapy trials of the EORTC (#22931) and RTOG (# 9501)

  title={Defining risk levels in locally advanced head and neck cancers: A comparative analysis of concurrent postoperative radiation plus chemotherapy trials of the EORTC (\#22931) and RTOG (\# 9501)},
  author={Jacques Bernier and Jay Scott Cooper and Thomas F. Pajak and Martine van Glabbeke and Jean Bourhis and Arlene A. Forastiere and Esat Mahmut Ozsahin and John R. Jacobs and Jacek Jassem and Kie Kian Ang and Jean Louis Lefebvre},
  journal={Head \& Neck},
BACKGROUND In 2004, level I evidence was established for the postoperative adjuvant treatment of patients with selected high-risk locally advanced head and neck cancers, with the publication of the results of two trials conducted in Europe (European Organization Research and Treatment of Cancer; EORTC) and the United States (Radiation Therapy Oncology Group; RTOG. [] Key MethodRESULTS Extracapsular extension (ECE) and/or microscopically involved surgical margins were the only risk factors for which the…

Chemotherapy in the treatment of locally advanced head and neck cancer

The evolution of current indications for this multimodality approach is reviewed and current areas of investigation discussed and the focus of future trials should be on survival improvement, toxicity reduction and risk stratification for treatment decision making.

Postoperative treatment for head and neck cancer: the emerging role of EGFR-targeted therapy

Pivotal randomized trials reported in the early 90s showed that postoperative radiotherapy results in better locoregional control than preoperative radi therapy and that the optimal dose is reached at about 63 Gy.

Postoperative Combined Modality Treatment in High Risk Resected Locally Advanced Squamous Cell Carcinomas of the Head and Neck (HNSCC)

The introduction of immune checkpoint inhibitors to the therapeutic armamentarium for recurrent/metastatic head and neck cancer patients has led to clinical investigation of incorporation of PD-1 inhibition in the postoperative setting.

The addition of chemotherapy to adjuvant radiation is associated with inferior survival outcomes in intermediate‐risk HPV‐negative HNSCC

Only high‐risk tumors with extranodal extension (ENE) and/or positive surgical margins (PSM) benefit from adjuvant therapy (AT) with concurrent chemoradiation (CRT) compared to radiation therapy (RT)

Management of squamous cell carcinoma of the head and neck: updated European treatment recommendations

Preclinical work in signaling pathways and other oncogenic factors (e.g., human papillomavirus infection) will be the key to improving outcomes of head and neck cancer patients in the future.

Adjuvant therapy in patients with resected poor-risk head and neck cancer.

Level I evidence regarding improved efficacy in this setting for the concurrent administration of chemotherapy and radiotherapy is produced, and high-dose cisplatin and irradiation can now be considered the standard therapeutic approach for resected poor-risk disease.

Evolution of treatment and high-risk features in resectable locally advanced Head and Neck squamous cell carcinoma with special reference to extracapsular extension of nodal disease.

  • V. Krstevska
  • Medicine
    Journal of B.U.ON. : official journal of the Balkan Union of Oncology
  • 2015
It can be concluded that strong evidence exists for an improved outcome for high-risk resected patients treated with adjuvant CCRT, and Precise definition of the presence of ECE is highly recommended in order to provide proper selection of patients who would benefit from the postoperative C CRT.


Evidence supporting the role of adjuvant RT includes an analysis by the Surveillance, Epidemiology and End Results (SEER) program of node-positive head and neck cancer patients reporting an absolute 10% overall and cause-specific survival benefit at 5 years.

Systemic Treatment for Squamous Cell Carcinoma of the Head and Neck.




Adjuvant chemotherapy for resectable squamous cell carcinomas of the head and neck: report on Intergroup Study 0034.

Postoperative concurrent radiotherapy and chemotherapy for high-risk squamous-cell carcinoma of the head and neck.

Among high-risk patients with resected head and neck cancer, concurrent postoperative chemotherapy and radiotherapy significantly improve the rates of local and regional control and disease-free survival, however, the combined treatment is associated with a substantial increase in adverse effects.

Implications of positive surgical margins

The recently concluded Head and Neck Intergroup trial tested the addition of three courses of cis‐platinum containing chemotherapy to standard treatment of surgery and postoperative radiotherapy for

Postoperative irradiation with or without concomitant chemotherapy for locally advanced head and neck cancer.

Postoperative concurrent administration of high-dose cisplatin with radiotherapy is more efficacious than radiotherapy alone in patients with locally advanced head and neck cancer and does not cause an undue number of late complications.

Precisely defining high‐risk operable head and neck tumors based on rtog #85‐03 and #88‐24: Targets for postoperative radiochemotherapy?

Local‐regional recurrence of disease remains the major obstacle to cure of advanced head and neck cancers.

Importance of the treatment package time in surgery and postoperative radiation therapy for squamous carcinoma of the head and neck

To determine the effect of treatment time‐related factors on outcome in patients treated with surgery and postoperative radiation therapy (RT) for locally advanced squamous cell carcinoma of head and

Nonparametric Estimation from Incomplete Observations

Abstract In lifetesting, medical follow-up, and other fields the observation of the time of occurrence of the event of interest (called a death) may be prevented for some of the items of the sample