Outcome comparisons of four radiation therapy oncology group (RTOG) trials in patients with stage IV-T4 head and neck (H/N) cancer: Encouraging results using intra-arterial (IA) cisplatin (P) and concurrent radiation therapy (RT)

5527 Background: We conducted a comparison of overall survival (OS) and local-regional tumor control (LC) outcomes in patients with stage IV-T4 disease originating from the oral cavity, oropharynx or hypopharynx among 4 RTOG H/N trials using RT +/- chemotherapy. Methods: The four compared RTOG trials and their treatment regimens were as follows: 1. RTOG 8117–standard fractionated (SFX) RT [66 –73.8 Gy] & 3 cycles of concurrent IV P (100 mg/m2); 2. RTOG 9003 –SFX RT (70 Gy in 7 weeks) alone [Arm 1], & accelerated fractionated (fx) RT with concomitant boost (AFX-C) [72 Gy in 42 fxs over 6 weeks] [Arm 4]; 3. RTOG 9703–concurrent SFX RT (70 Gy/7 weeks in arms 1 and 3, and q other week over 13 weeks in arm 2] with IV daily P (10 mg/m2) / 5-FU (400 mg/m2 d/ CI last 2 wks of RT) [Arm 1], q other week of IV 5-FU (800 mg/m2/d x 5 days) / Hydroxyurea (1 gm po bid x 6 days) [Arm 2], or weekly IV P (20 mg/m2) / Taxol (30 mg/m2) [Arm 3]; & 4. RTOG 9615 –intra-arterial (IA) weekly P (100 mg/m2) x 4 weeks with SFX RT (7...