Improved outcomes from addition of cisplatin to hyperfractionated radiotherapy

A paper in the Journal of Clinical Oncology found that the addition of two cycles of cisplatin to hyperfractionated radiotherapy significantly improved outcomes in patients with resectable squamous cell carcinomas of the head and neck, with a trend towards improved overall survival.Patients with resectable squamous cell carcinomas of the head and neck can be treated with surgery with or without radiotherapy and the choice depends on the extent and site of the tumour, comorbidity and patient preference. The combination of radiotherapy with chemotherapy and use of altered fractionation are options that may improve local or regional control and survival. The optimum combination of radiotherapy and chemotherapy that has highest efficacy but minimal toxicity is unclear. This randomised trial compared 111 patients given hyperfractionated radiotherapy with 112 patients given combined treatment of the same radiotherapy and moderate dose cisplatin. Radiotherapy was given for seven weeks with 1.2 Gy given twice daily six hours apart to a median total dose of 74.4 Gy. Cisplatin at 20 mg/m2 was given on five consecutive days in weeks one and five or six of radiotherapy. Eighty one percent of patients were stage T3 or T4 and 29% were N3 with bilateral or bulky neck nodes....