Synchronous chemoradiation for squamous carcinomas

BMJ 2001; 322 doi: https://doi.org/10.1136/bmj.322.7291.876 (Published 14 April 2001) Cite this as: BMJ 2001;322:876

This has become the new gold standard—whatever the primary site

  1. Jeffrey S Tobias, consultant in radiotherapy and oncology,
  2. David Ball, head, lung unit
  1. Meyerstein Institute of Oncology, Middlesex Hospital, London W1T 3AA
  2. Department of Radiation Oncology, Peter MacCallum Cancer Institute, Locked Bag 1, A'Beckett St, Melbourne, Vic 8006, Australia

    For many decades the primary treatment for common cancers has mostly been radical surgical resection (for example, for cancers of the large bowel, lung (non-small cell), kidney) or radical radiotherapy for inoperable cases or when tissue preservation is desirable and the cancer sufficiently radiosensitive (for example, cancers of the head and neck, notably larynx). Surgery and radical radiotherapy are sometimes competitors, but in other cancers (such as breast cancer) limited surgical intervention and radiotherapy used conjointly can offer the best compromise between the twin requirements of excellent local control with tissue preservation and near perfect cosmesis. Over the past few years a quiet revolution has been taking place, dramatically altering the treatment options in a surprisingly large proportion of patients with solid tumours. For patients with a squamous primary cancer at most of the common sites it is increasingly clear that traditional treatment with surgical excision, radiation therapy—or both—no longer offers the best possible choice.

    Giving chemotherapy in the adjuvant setting—shortly after completion of primary surgery or radiation therapy—has often been regarded as the best possible use of this valuable but demanding …

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