Analysis of treatment failure patterns. A Southwest Oncology Group Study

If chemotherapy is effectively controlling microscopic distant metastases, then a reduced number of patients would experience treatment failure at distant sites. This study has used a group of 175 patients on a phase 3 Southwest Oncology Group trial for resectable advanced stage disease to test this hypothesis. In the group that failed, 52% of the standard group failed at distant sites as opposed to only 30% of the experimental group. This difference approaches statistical significance. These findings suggest that chemotherapy, although demonstrating some activity against microscopic distant disease, has not substantially altered the usual patterns of treatment failure for head and neck cancer. However, the assumption that the clinical responses noted with chemotherapy are having a positive influence on the frequency of occult distant disease was supported by our results.