Correspondence

Chemotherapy in Unresectable Head and Neck Cancer

N Engl J Med 2008; 358:1075March 6, 2008

Article

To the Editor:

Radiotherapy alone in patients with advanced head and neck cancer is not the treatment of choice, even when cisplatin, fluorouracil, and docetaxel (TPF) are given. Vermorken et al. (Oct. 25 issue)1 report that TPF improved progression-free and overall survival in patients with unresectable head and neck cancer, but their results are disappointing as compared with chemoradiotherapy2,3 or radiotherapy with cetuximab.4 In the same issue, Posner et al. also report better results in patients with advanced head and neck cancer when TPF was combined with radiotherapy.5

Edwin Bölke, M.D.
Matthias Peiper, M.D.
Stephan Gripp, M.D.
University of Düsseldorf, 40225 Düsseldorf, Germany
boelke@med.uni-duesseldorf.de

5 References

1. 1

   Vermorken JB, Remenar E, van Herpen C, et al. Cisplatin, fluorouracil, and docetaxel in unresectable head and neck cancer. N Engl J Med 2007;357:1695-1704
   Full Text | Web of Science | Medline

2. 2

   Budach W, Hehr T, Budach V, Belka C, Dietz K. A meta-analysis of hyperfractionated and accelerated radiotherapy and combined chemotherapy and radiotherapy regimens in unresected locally advanced squamous cell carcinoma of the head and neck. BMC Cancer 2006;6:28-28
   CrossRef | Web of Science | Medline

3. 3

   Brizel DM, Esclamado R. Concurrent chemoradiotherapy for locally advanced, nonmetastatic, squamous carcinoma of the head and neck: consensus, controversy, and conundrum. J Clin Oncol 2006;24:2612-2617
   CrossRef | Web of Science | Medline

4. 4

   Bonner JA, Harari PM, Giralt J, et al. Radiotherapy plus cetuximab for squamous-cell carcinoma of the head and neck. N Engl J Med 2006;354:567-578
   Full Text | Web of Science | Medline

5. 5

   Posner MR, Hershock DM, Blajman CR, et al. Cisplatin and fluorouracil alone or with docetaxel in head and neck cancer. N Engl J Med 2007;357:1705-1715
   Full Text | Web of Science | Medline

Author/Editor Response

We agree with Bölke et al. that radiotherapy alone as locoregional treatment is usually not the treatment of choice for locoregionally advanced head and neck cancer. This is also clearly indicated in the second paragraph of our article. We also state that accelerated or hyperfractionated radiotherapy regimens, which have recently been shown to be superior to conventionally fractionated radiotherapy, were used in only a minority of patients, because at the time our trial started, these standards had not been universally accepted within the European Organization for Research and Treatment of Cancer (EORTC) Head and Neck Cancer Group. However, we would caution against cross-trial comparisons, because patient and tumor characteristics can vary widely.

Jan B. Vermorken, M.D., Ph.D.
Antwerp University Hospital, 2650 Edegem, Belgium
jan.b.vermorken@uza.be

Citing Articles (1)

Citing Articles

1. 1

   Edwin Bölke*, Gisela Schieren*, Stephan Gripp, Gerald Steinbach, Matthias Peiper, Klaus Orth, Christiane Matuschek, Maximilian Pelzer, Guido Lammering, Ruud Houben, Christina Antke, Lars Christian Rump, Rodrigo Mota, Peter Arne Gerber, Patrick Schuler, Thomas K. Hoffmann, Ethelyn Rusnak, Derik Hermsen*, Wilfried Budach*. (2011) Cystatin C – A Fast and Reliable Biomarker for Glomerular Filtration Rate in Head and Neck Cancer Patients. Strahlentherapie und Onkologie 187:3, 191-201
   CrossRef