Locoregionally advanced squamous cell carcinoma of the head and neck: chemoradiation or bioradiation

Concurrent high-dose cisplatin-based chemoradiation (CCRT) is the preferred standard of care for patients with locoregionally advanced squamous cell carcinoma of the head and neck (LA-HNSCC) (1,2). The addition of cetuximab to irradiation (RT) improves locoregional control and prolongs progression-free survival (PFS) and overall survival (OS) (3,4). The combination of an EGFR-directed monoclonal antibody and cisplatin-based CCRT is not superior to cisplatin-based CCRT alone, but adds toxicity, and is therefore not recommended (5,6). Until recently, there were no direct comparisons between cisplatin-based CCRT and RT + cetuximab. Nevertheless, RT + cetuximab are widely rumored to be less toxic than cisplatin-based CCRT and is commonly advocated in patients unsuitable for cisplatin-based CCRT (7).