Hyperfractionated radiotherapy, combined with chemotherapy, has proved the best treatment for head and neck cancers that have begun to spread, a major European conference will hear today.
The treatment, involving twice daily doses of radiation, reduced mortality by 20% compared with giving one dose of radiotherapy daily, according to the analysis to be reported to the European Cancer Congress in Amsterdam, the Netherlands.
Dr Claire Petit, of the Gustave Roussy centre, Paris, France, conducted a network metanalysis of 117 different international trials involving nearly 30,000 patients.
The study compared 16 different treatments to identify the most effective.
She reports that hyperfractionated radiotherapy with chemotherapy reduced mortality by 20% compared with the best standard treatment of chemotherapy with once-daily radiotherapy. And it reduced the risk of deterioration by 23%.
But the researchers say they were unable to compare side-effects from the treatments.
Dr Petit said: “There are a number of new treatments that have shown promise in head and neck cancer trials.
"This large study has enabled us to compare several of these treatments to see which is best overall in terms of reducing mortality.”
She added: “Moreover, the method we used, network meta-analysis, which combines direct and indirect treatment comparisons, is a new method that needs to be interpreted with prudence.
“However, this is an important finding for this group of patients who have a higher risk of their cancer recurring following treatment.”
Professor Philip Poortmans, president-elect of the European Cancer Organisation and a radiation oncology specialist in the Netherlands, called for prospective trials to confirm the findings.
He said: This research provides good evidence for the benefits of treating advanced stage head and neck cancer patients with a combination of twice-daily radiation therapy and chemotherapy, compared to one or even none of these separately.
"Before we can apply these very interesting results into daily clinical practice, we need to wait for the outcome of the next stage of this research – namely the evaluation of the short and long-term side effects. This is of utmost importance for the quality of life of the patients and their relatives."
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