The Slippery Role of Induction Chemotherapy in Head and Neck Cancer: Myth and Reality.

In the RTOG 91-11, sequential CHT (with PF as induction) followed by RTX was compared to concomitant CRT and RTX alone in patients with locally-advanced laryngeal cancer (excluding T4 tumors with invasion through the full-thickness of the thyroid cartilage or base of tongue involvement), OS did not differ significantly between induction and concomitant arms, although the 10-year update analyses showed a trend toward a worse OS with concomitant CRT vs. sequential treatment (HR 1.25; 95% CI, 0.98–1.61; p = 0.08).

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There was a strong trend for superior OS for high risk tumors (N2c and N3), but power was very low in this subgroup analysis with only 47 high-risk patients randomized.

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