Abstract
The MACH-NC analysis demonstrated a 6.5 % absolute improvement in 5-year overall survival with concurrent chemoradiotherapy (CCRT) over radiotherapy (RT) alone. High-dose cisplatin (100 mg/m2 on days 1, 22, and 43 during RT) was identified as the most effective regimen. Definitive CCRT with high-dose cisplatin is therefore regarded as the preferred choice for the treatment of locoregionally advanced head and neck squamous cell cancer. However, this approach is hampered by acute and late toxic effects. In particular, the late toxicity has major implications for the quality of life of the cancer survivors. In a multivariate analysis of three studies in which patients were treated with cisplatin-based CCRT, older age, advanced tumor stage, larynx/hypopharynx primary site, and neck dissection following CCRT proved to be strong independent risk factors in predicting severe late toxicity and complications.
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