Trial reportAnnals of oncology : official journal of the European Society for Medical Oncology2025
Re-examining post-operative chemoradiotherapy in head and neck cancer: an updated long-term combined analysis of RTOG 9501/EORTC 22931.
Trial report in Annals of oncology : official journal of the European Society for Medical Oncology, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 9 papers, 1 of them a synthesis that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
9 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Immuno-oncology in the perioperative setting: the next frontier in resectable head and neck cancers - a systematic review.BMC cancer · 2026Pooled it
- Treatment-related lymphopenia predicts long-term survival in locally advanced head and neck cancer:Frontiers in immunology · 2026Trial
- Multicentre patterns-of-care analysis of adjuvant and definitive (chemo)radiotherapy for pharyngeal and laryngeal carcinoma in Franconia, Germany.Strahlentherapie und Onkologie : Organ der Deutschen Rontgengesellschaft ... [et al] · 2026Observational
- Article
- Exploratory immunomonitoring during radiochemotherapy in HNSCC and machine-learning reveal immune parameters associated with disease-free survival.NPJ precision oncology · 2026Article
- [Neck dissection-more, less, targeted?]HNO · 2026Review
- De-escalation of head-and-neck cancer radiotherapy: balancing cure and side effects.Frontiers in oncology · 2026Review
- Concurrent chemoradiotherapy vs. total laryngectomy in locally advanced laryngeal squamous cell carcinoma: a propensity score-matched retrospective cohort study.American journal of cancer research · 2026Article
- The Evolution of Clinical Practice Guidelines for the Postoperative Treatment of Human Papillomavirus-Associated Oropharyngeal Squamous Cell Carcinoma: Comments and Controversies.Practical radiation oncologyArticle
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
17 authors.
Funding
Abstract
backgroundPost-operative chemoradiation (CRT) is generally recommended for head and neck cancer patients with extranodal extension (ENE) and/or positive margins, but not for patients without these features, based on a post hoc analysis of Radiation Therapy Oncology Group (RTOG) 9501 and European Organisation for Research and Treatment of Cancer (EORTC) 22931. However, this analysis lacked tests of interaction necessary to identify a predictive biomarker. In addition, updated data are now available. PATIENTS AND
methodsThis study assessed 744 patients enrolled on RTOG 9501 and EORTC 22931, randomized trials that compared CRT with radiation (RT) following surgery. Overall survival (OS) was analyzed with Cox regression. Cancer-specific mortality (CSM), other-cause mortality (OCM), and recurrence outcomes were analyzed with competing risks methodology. Tests of interaction assessed for differential benefits of CRT in various subgroups.
resultsMedian follow-up was 6.9 years. Among all patients, CRT improved OS [hazard ratio (HR) 0.81, 95% confidence interval (CI) 0.68-0.97, P = 0.026]. Although CRT improved OS in the subgroup with ENE and/or positive margins (HR 0.71, 95% CI 0.57-0.89, P = 0.003) and not in those without these features (HR 0.94, 95% CI 0.68-1.30, P = 0.7), tests of interaction showed no evidence of a differential effect of CRT in these subgroups (P-interaction = 0.17). There was also no evidence of interaction when analyzing other outcomes, or when assessing ENE and margin status individually. While CRT significantly reduced CSM (HR 0.68, 95% CI 0.55-0.83, P < 0.001), it also significantly increased OCM (HR 1.51, 95% CI 1.07-2.12, P = 0.018). Post-operative CRT improved locoregional recurrence (HR 0.64, 95% CI 0.48-0.85, P = 0.002), but not distant metastasis (HR 0.83, 95% CI 0.64-1.08, P = 0.17).
conclusionsConcurrent chemotherapy improved OS in head and neck cancer patients undergoing post-operative radiotherapy in the combined populations of EORTC 22931 and RTOG 9501. ENE and/or positive margins are not predictive biomarkers, and patients without these features may still benefit from CRT. CRT improved CSM, but this was partly offset by higher OCM. Refining the population most likely to benefit from post-operative CRT, taking into consideration both oncologic and patient-related factors, needs further exploration.
Indexed as
Identifiers
What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.