***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: Background Human papillomavirus (HPV)-related head and neck cancer has been associated with an improved prognosis in patients treated with radiotherapy ( RT ) + /− chemotherapy ( CT ) ;  however , RT combined with epidermal growth factor receptor ( EGFR ) inhibitors has not been fully studied in this group of patients . Methods Immunohistochemical expression of p16 and PCR of HPV16 DNA were retrospectively analyzed in tumor blocks from 108 stage III/IV head and neck cancer patients treated with RT+CT ( 56 ) or RT+EGFR inhibitors ( 52 )  . Disease-free survival ( DFS ) and overall survival ( OS ) were analyzed by the Kaplan-Meier method . Results DNA of HPV16 was found in 12 of 108 tumors ( 11 % ) and p16 positivity in 18 tumors ( 17 % ) , with similar rates in both arms of treatment . After a median follow-up time of 35 months ( range 6–135 ) , p16-positive patients treated with RT+EGFR inhibitors showed improved survival compared with those treated with RT+CT ( 2-year OS 88 % vs. 60 % , HR 0.18 ; 95 % CI 0.04 to 0.88 ; p = 0.01 ; and 2-year DFS 75 % vs. 47 % , HR 0.17 ; 95 % CI 0.03 to 0.8 ; p = 0.01 ) . However , no differences were observed in p16-negative patients ( 2-year OS 56 % vs. 53 % , HR 0.97 ; 95 % CI 0.55 to 1.7 ; p = 0.9 ; and 2-year DFS 43 % vs. 45 % , HR 0.99 ; 95 % CI 0.57 to 1.7 ; p = 0.9 ) . Conclusions This is the first study to show that p16-positive patients may benefit more from RT+EGFR inhibitors than conventional RT+CT . These results are hypothesis-generating and should be confirmed in prospect i ve trials BACKGROUND We conducted a multinational , r and omized study to compare radiotherapy alone with radiotherapy plus cetuximab , a monoclonal antibody against the epidermal growth factor receptor , in the treatment of locoregionally advanced squamous-cell carcinoma of the head and neck . METHODS Patients with locoregionally advanced head and neck cancer were r and omly assigned to treatment with high-dose radiotherapy alone ( 213 patients ) or high-dose radiotherapy plus weekly cetuximab  ( 211 patients ) at an initial dose of 400 mg per square meter of body-surface area , followed by 250 mg per square meter weekly for the duration of radiotherapy . The primary end point was the duration of control of locoregional disease ; secondary end points were overall survival , progression-free survival , the response rate , and safety . RESULTS The median duration of locoregional control was 24.4 months among patients treated with cetuximab plus radiotherapy and 14.9 months among those given radiotherapy alone ( hazard ratio for locoregional progression or death , 0.68 ; P=0.005 ) . With a median follow-up of 54.0 months , the median duration of overall survival was 49.0 months among patients treated with combined therapy and 29.3 months among those treated with radiotherapy alone ( hazard ratio for death , 0.74 ; P=0.03 ) . Radiotherapy plus cetuximab significantly prolonged progression-free survival ( hazard ratio for disease progression or death , 0.70 ; P=0.006 ) . With the exception of acneiform rash and infusion reactions , the incidence of grade 3 or greater toxic effects , including mucositis , did not differ significantly between the two groups . CONCLUSIONS Treatment of locoregionally advanced head and neck cancer with concomitant high-dose radiotherapy plus cetuximab improves locoregional control and reduces mortality without increasing the common toxic effects associated with radiotherapy to the head and neck . ( Clinical Trials.gov number , NCT00004227 . BACKGROUND The phase III EXTREME and CRYSTAL studies demonstrated that the addition of cetuximab to chemotherapy significantly improved survival in the first-line treatment of recurrent/metastatic squamous cell carcinoma of the head and neck ( SCCHN ) and KRAS wild-type metastatic colorectal cancer ( mCRC ) . In advanced non-small-cell lung cancer ( NSCLC ) , high EGFR expression was identified as a tumour biomarker that can predict survival benefit associated with the addition of cetuximab to first-line chemotherapy . We investigated whether tumour EGFR expression level was predictive of cetuximab benefit in EXTREME and CRYSTAL study patients . METHODS Prospect ively collected tumour immunohistochemistry data were used to generate an EGFR immunohistochemistry score ( scale 1 - 300 ) for patients in the EXTREME and CRYSTAL studies . For each study , the association between tumour immunohistochemistry score and cetuximab benefit was investigated . The EXTREME and CRYSTAL studies are registered with Clinical Trials.gov , numbers NCT00122460 and NCT00154102 , respectively . FINDINGS Tumour EGFR immunohistochemistry data were available for 411 of 442 ( 93 % ) patients from the EXTREME study intention-to-treat ( ITT ) population and 664 of 666 ( 100 % ) patients from the ITT population of the CRYSTAL study with EGFR-expressing , KRAS wild-type disease . The distribution of immunohistochemistry scores was similar between the treatment arms of each study , but differed between studies . A clinical ly relevant benefit for progression-free and overall survival associated with the addition of cetuximab to chemotherapy was seen across the full score range in EXTREME study patients . Similarly , CRYSTAL study patients derived a clinical benefit across the full score range , with no meaningful association between EGFR expression level and benefit . INTERPRETATION The addition of cetuximab to chemotherapy improved survival in the first-line treatment of recurrent/metastatic SCCHN and KRAS wild-type mCRC regardless of tumour EGFR expression level , indicating that in contrast to findings in NSCLC , EGFR expression level is not a clinical ly useful predictive biomarker in these setting BACKGROUND The role of neoadjuvant chemoradiotherapy in the treatment of patients with esophageal or esophagogastric-junction cancer is not well established . We compared chemoradiotherapy followed by surgery with surgery alone in this patient population . METHODS We r and omly assigned patients with resectable tumors to receive surgery alone or weekly administration of carboplatin ( doses titrated to achieve an area under the curve of 2 mg per milliliter per minute ) and paclitaxel ( 50 mg per square meter of body-surface area ) for 5 weeks and concurrent radiotherapy ( 41.4 Gy in 23 fractions , 5 days per week ) , followed by surgery . RESULTS From March 2004 through December 2008 , we enrolled 368 patients , 366 of whom were included in the analysis : 275 ( 75 % ) had adenocarcinoma , 84 ( 23 % ) had squamous-cell carcinoma , and 7 ( 2 % ) had large-cell undifferentiated carcinoma . Of the 366 patients , 178 were r and omly assigned to chemoradiotherapy followed by surgery  , and 188 to surgery alone . The most common major hematologic toxic effects in the chemoradiotherapy-surgery group were leukopenia ( 6 % ) and neutropenia ( 2 % ) ; the most common major nonhematologic toxic effects were anorexia ( 5 % ) and fatigue ( 3 % ) . Complete resection with no tumor within 1 mm of the resection margins ( R0 ) was achieved in 92 % of patients in the chemoradiotherapy-surgery group versus 69 % in the surgery group ( P<0.001 ) . A pathological complete response was achieved in 47 of 161 patients ( 29 % ) who underwent resection after chemoradiotherapy . Postoperative complications were similar in the two treatment groups , and in-hospital mortality was 4 % in both . Median overall survival was 49.4 months in the chemoradiotherapy-surgery group versus 24.0 months in the surgery group . Overall survival was significantly better in the chemoradiotherapy-surgery group ( hazard ratio , 0.657 ; 95 % confidence interval , 0.495 to 0.871 ; P=0.003 ) . CONCLUSIONS Preoperative chemoradiotherapy improved survival among patients with potentially curable esophageal or esophagogastric-junction cancer . The regimen was associated with acceptable adverse-event rates . ( Funded by the Dutch Cancer Foundation [ KWF Kankerbestrijding ] ; Netherl and s Trial Register number , NTR487 . ) BACKGROUND Concomitant chemoradiotherapy ( CT/RT ) is the st and ard treatment of locally advanced squamous cell carcinoma of the head and neck ( SCCHN ) . We evaluated the efficacy of induction docetaxel ( Taxotere ) , cisplatin , and 5-fluorouracil ( TPF ) before CT/RT versus CT/RT alone . PATIENTS AND METHODS Patients with stage III-IVM0 SCCHN , Eastern Cooperative Oncology Group performance status of zero to one , were r and omly assigned to receive CT/RT alone ( arm A : two cycles of cisplatin 20 mg/m(2 ) , days1 - 4 , plus 5-fluorouracil 800 mg/m(2)/day 96 h continuous infusion , during weeks 1 and 6 of radiotherapy ) or three cycles of TPF ( arm B : docetaxel 75 mg/m(2 ) and cisplatin 80 mg/m(2 ) , day 1 , and 5-fluorouracil 800 mg/m(2)/day 96 h continuous infusion , every 3 weeks ) followed by the same CT/RT . The primary end point was the rate of radiologic complete response ( CR ) at 6 - 8 weeks after the end of CT/RT . RESULTS A total of 101 patients were r and omly allocated to the study ( 51 arm A ; 50 arm B ) . CR rates were 21.2 % ( arm A ) versus 50 % ( arm B ) . Median progression-free survival and overall survival were , respectively , 19.7 and 33.3 months ( arm A ) and 30.4 and 39.6 months ( arm B ) . Hematologic and non-hematologic toxic effects during CT/RT were similar in the two arms . CONCLUSION Induction TPF followed by CT/RT was associated with higher radiologic CR  in patients with locally advanced SCCHN with no negative impact on CT/RT feasibility PURPOSE To compare the efficacy and safety of induction chemotherapy ( ICT ) followed by chemoradiotherapy ( CRT ) or bioradiotherapy ( BRT ) for larynx preservation ( LP ) . PATIENTS AND METHODS Previously untreated patients with stage III to IV larynx/hypopharynx squamous cell carcinoma received three cycles of ICT-docetaxel and cisplatin 75 mg/m(2 ) each on day 1 and fluorouracil 750 mg/m(2 ) per day on days 1 through 5 . Poor responders ( < 50 % response ) underwent salvage surgery . Responders ( ≥ 50 % response ) were r and omly assigned to conventional radiotherapy ( RT ; 70 Gy ) with concurrent cisplatin 100 mg/m(2 ) per day on days 1 , 22 , and 43 of RT ( arm A ) or concurrent cetuximab 400 mg/m(2 ) loading dose and 250 mg/m(2 ) per week during RT ( arm B ) . Primary end point was LP at 3 months . Secondary end points were larynx function preservation ( LFP ) and overall survival ( OS ) at 18 months . RESULTS Of the 153 enrolled patients , 116 were r and omly assigned after ICT ( 60 , arm A ; 56 , arm B ) . Overall toxicity of both CRT and BRT was substantial following ICT . However , treatment compliance was higher in the BRT arm . In an intent-to-treat analysis , there was no significant difference in LP at 3 months between arms A and B ( 95 % and 93 % , respectively ) , LFP ( 87 % and 82 % , respectively ) , and OS at 18 months ( 92 % and 89 % , respectively ) . There were fewer local treatment failures in arm A than in arm B ; salvage surgery was feasible in arm B only . CONCLUSION There is no evidence that one treatment was superior to the other or could improve the outcome reported with ICT followed by RT alone ( French Groupe Oncologie Radiothérapie Tête et Cou [ GORTEC ] 2000 - 01 trial [ Induction CT by Cisplatin , 5FU With or Without Docetaxel in Patients With T3 and T4 Larynx and Hypopharynx Carcinoma ] ) . The protocol 
    Output:
    
For the treatment of locally advanced HNSCC , platinum-based CTRT is associated with a better OS and PFS compared to RT+CET , and this is probably attributed to improved locoregional disease control .