Induction chemotherapy followed by concurrent chemoradiotherapy (sequential chemoradiotherapy) versus concurrent chemoradiotherapy alone in locally advanced head and neck cancer (PARADIGM): a randomised phase 3 trial

Haddad, Robert I.; O’Neill, Anne; Rabinowits, Guilherme; Tishler, Roy B.; Khuri, Fadlo R.; Adkins, Douglas R.; Clark, Joseph I.; Sarlis, Nicholas J.; Lorch, Jochen H.; Beitler, Jonathan J.; Limaye, Sewanti; Riley, Sarah; Posner, Marshall R.

doi:10.1016/s1470-2045(13)70011-1

Cited by 637 publications

(459 citation statements)

References 19 publications

Supporting

Mentioning

430

Contrasting

Unclassified

Order By: Relevance

“…4). This is in line with the results of recently reported randomized trials studying the role of induction chemotherapy in addition to CCRT, but in disagreement with the most recently reported Italian trial, which claimed a beneficial effect on survival by using a TPF regimen in addition to CCRT/BRT [51][52][53][54]. It is merely speculative in trying to explain why we did not find a difference between the two approaches; there were certainly a significantly higher number of stage IV patients in the group treated with IT than in the group treated with CCRT/BRT alone (96% vs. 71%, p 5 .0053).…”

Section: Discussionsupporting

confidence: 67%

Helical Tomotherapy in Head and Neck Cancer: A European Single-Center Experience

Gestel¹,

Weyngaert

Kerf³

et al. 2015

The Oncologist

View full text Add to dashboard Cite

Background. We report on a retrospective analysis of 147 patients with early and locoregionally advanced squamous cell head and neck cancer (SCCHN) treated with helical tomotherapy (HT). Patients and Methods. Included were patients with SCCHN of the oral cavity (OC), oropharynx (OP), hypopharynx (HP), or larynx (L) consecutively treated in one radiotherapy center in 2008 and 2009.The prescribed HT dose was 60-66 Gy in the postoperative setting (group A) and 66-70 Gy when given as primary treatment (group B). HT was given alone, concurrent with systemic therapy (ST), that is, chemotherapy, biotherapy, or both, and with or without induction therapy (IT). Acute and late toxicities are reportedusing standard criteria; locoregional failure/progression (LRF), distant metastases (DM), and second primary tumors (SPT) were documented, and event-free survival (EFS) and overall survival (OS) were calculated from the start of HT.

show abstract

Section: Discussionsupporting

confidence: 67%

Helical Tomotherapy in Head and Neck Cancer: A European Single-Center Experience

Gestel¹,

Weyngaert

Kerf³

et al. 2015

The Oncologist

View full text Add to dashboard Cite

show abstract

“…These findings are also supported in induction studies DECIDE and PARADIGM for other head and neck sites where the induction arm had significantly more adverse events compared to the concurrent CRT alone arm. These studies also did not find an OS benefit with induction therapy 32, 33…”

Section: Discussionmentioning

confidence: 89%

Induction chemotherapy in the treatment of nasopharyngeal carcinoma: Clinical outcomes and patterns of care

et al. 2018

Self Cite

View full text Add to dashboard Cite

The role of induction chemotherapy in nasopharyngeal carcinoma (NPC) remains controversial. The primary aim of this study was to use the National Cancer Database to evaluate the patterns of care of induction chemotherapy in NPC and its impact on overall survival (OS). Patients with NPC from 2004 to 2014 were obtained from the NCDB. Patients were considered to have received induction chemotherapy if it was started ≥43 days before the start of RT and concurrent CRT if chemotherapy started within 21 days after the start of RT. Propensity score matching was used to control for selection bias. Cox proportional hazards model was used to determine significant predictors of OS. Logistic regression model was used to determine predictors of the use of induction chemotherapy. Significance was defined as a P value <.05. A total of 4857 patients were identified: 4041 patients (87.2%) received concurrent CRT and 816 patients (16.8%) received induction chemotherapy. The use of induction therapy remained stable between 2004 and 2014. Younger patients and those with higher T‐ and N‐stage had a higher likelihood of being treated with induction chemotherapy. The 5‐year OS in patients treated with induction chemotherapy and CRT was 66.3% vs 69.1%, respectively (P = .25). There was no difference in OS when these two groups were analyzed after propensity score matching. No differences in OS existed between these treatment groups in patients with T3‐T4N1 or TanyN2‐3 disease (P = .76). Propensity score matching also did not reveal any difference in OS in patients with T3‐T4N1 or TanyN2‐3 disease. The use of induction chemotherapy has remained stable in the last decade. In this study of patients with NPC, induction chemotherapy was not associated with improved OS compared to CRT alone.

show abstract

“…However, in the era of concurrent chemoradiotherapy, additional induction chemotherapy has been controversial for hypopharyngeal cancer. For head and neck cancer, there have been several randomized trials comparing induction chemotherapy followed by concurrent chemoradiotherapy and primary concurrent chemoradiotherapy (25)(26)(27). However, additional induction treatment did not improve overall survival, and severe toxicity was frequently observed due to cumulative chemotherapy (25).…”

Section: Discussionmentioning

confidence: 99%

“…For head and neck cancer, there have been several randomized trials comparing induction chemotherapy followed by concurrent chemoradiotherapy and primary concurrent chemoradiotherapy (25)(26)(27). However, additional induction treatment did not improve overall survival, and severe toxicity was frequently observed due to cumulative chemotherapy (25). A meta-analysis of radiotherapy and chemotherapy in head and neck cancer showed that there was no clear evidence of a benefit for induction chemotherapy (28).…”

Section: Discussionmentioning

confidence: 99%

Clinical Outcomes of Definitive and Postoperative Radiotherapy for Stage I-IVB Hypopharyngeal Cancer

Shirai

Saitoh

Abe

et al. 2016

View full text Add to dashboard Cite

Induction chemotherapy followed by concurrent chemoradiotherapy (sequential chemoradiotherapy) versus concurrent chemoradiotherapy alone in locally advanced head and neck cancer (PARADIGM): a randomised phase 3 trial

Cited by 637 publications

References 19 publications

Helical Tomotherapy in Head and Neck Cancer: A European Single-Center Experience

Helical Tomotherapy in Head and Neck Cancer: A European Single-Center Experience

Induction chemotherapy in the treatment of nasopharyngeal carcinoma: Clinical outcomes and patterns of care

Clinical Outcomes of Definitive and Postoperative Radiotherapy for Stage I-IVB Hypopharyngeal Cancer

Contact Info

Product

Resources

About