NOTE

🌱 created from: head_and_neck_squamous_cell_cancer

role_of_chemoradiation-hnscc

• Concurrent CRT: Used as alternative to surgery for organ preservation or for unresectable dz
• CRT for locally advanced dz: CIS CRT ↑ OS but also ↑ tox (cytopenias, renal, n/v) (JCO 2003;21:92). Carbo + 5-FU CRT ↑ OS in oropharyngeal (JCO 2004;22:69); cetuximab CRT ↓ OS & ↓ locoregional control in HPV+ locally advanced dz compared to CIS RT (RTOG 1016, Lancet 2019; 393:40; Lancet 2019;393:51)
• Cumulative dose of
  • CIS >200 mg/m2
  • is rec regardless of bolus or weekly dosing
• Larynx preservation improved w/ concurrent CIS + RT (RTOG 91, JCO 2013;31:845)
• Postop adj. CRT w/ CIS for high-risk features of (+) margins or ENE in LN (Head Neck 2005;27:843): ↑ DFS (NEJM 2004;350:1937) & OS (NEJM 2004;350:1945)