DeCIDE and PARADIGM: nails in the coffin of induction chemotherapy in head and neck squamous cell carcinoma?

Excerpt

Induction chemotherapy was first used in squamous cell carcinoma of the head and neck (SCCHN) in the 1970s. High overall response rates were observed in previously untreated tumours [1] and a correlation between response to induction chemotherapy and favourable outcome following radiotherapy was noted [2]. Numerous subsequent randomised studies and meta-analyses nonetheless failed to demonstrate a significant survival advantage with the use of induction chemotherapy compared with locoregional treatment alone [3]. A marginally significant 5 % absolute improvement in 5 year survival was seen when analysis was restricted to studies using a platin and 5-fluorouracil (PF) as the induction regimen. This was however overshadowed by the larger survival benefit observed with concurrent chemoradiation (CRT). As a result, CRT became widely accepted as the standard of care in the non-surgical management of patients with locoregionally advanced SCCHN. …