A comparison of radiotherapy or radiochemotherapy with symptomatic treatment alone in patients with advanced head and neck carcinomas

The choice of palliative treatment and the prognostic factors in unresectab le head and neck cancer cases continue to be controversial. In the present study we compared the survival rates of untreated stage IV head and neck ca ncer patients with cases managed prospectively at A.C. Camargo Hospital for Cancer with neoadjuvant chemotherapy, concomitant chemotherapy or radiothe rapy alone. Previous results had shown that while the type of treatment did not influence survival rates (P = 0.706), tumor response to treatment (whe ther complete, partial or none) significantly influenced survival (P = 0.00 002). In the present study we compared the survival rates in the groups wit h untreated patients (who remained untreated until death) with the same dem ographic and clinical characteristics of patients receiving treatment. We f ound that there was a significant difference between the survival rates of the untreated group and those of the treated groups that was independent of the type of treatment performed (P < 0.00001) or the tumor response to tre atment (P < 0.0001).