Combined therapy in advanced stages (III and IV) of XXXX increases the possibility of cure: results of a large controlled clinical trial.

@entity1 @entity137 @entity66 @entity706 @entity4349 @entity2590 @entity3052 @entity1370 @entity1349
OBJECTIVES: We evaluate the long-term results of a randomized clinical trial in @entity1 with advanced stages (III and IV) of @entity706 using chemotherapy or combined therapy (chemotherapy following by adjuvant radiotherapy in @entity1 with @entity66 ). MATERIAL AND METHODS: Between 1981 and 1995, @entity1 with @entity706 were treated with combined chemotherapy, mostly @entity4349 -based regimens; @entity1 who achieved complete response were randomly assigned either to receive adjuvant radiotherapy to sites or to @entity66 or not (control group). RESULTS: Four hundred and sixty-nine @entity1 were randomized; in an intent-to-treat analysis all were evaluable for efficacy and @entity137 . Actuarial curves at 20yr showed that event-free survival (EFS) and @entity1349 ( @entity1349 ) in the control group were 41% [95% confidence interval (CI) 36-56%) and 71% (95% CI 65-78%), respectively; these were statistically different from results for the @entity1 who received adjuvant radiotherapy: 68% (95% CI 62-72%) and 89% (95% CI 79-96%), respectively (P<0.01). Acute and late @entity137 were minimal; only four @entity1 (<1%) developed @entity2590 / @entity3052 . @entity1370 was 2%, but one case was lethal. Thirty-six @entity1 (8%) died secondary to unrelated causes, in complete remission. CONCLUSIONS: The use of adjuvant radiotherapy in @entity1 with poor-prognosis @entity706 increases EFS and @entity1349 with minimal @entity137 . We feel that @entity706 should be treated curatively because <80% of @entity1 will be in first complete response at <20yr. The use of adjuvant radiotherapy will be considered in the first line of treatment in this set of @entity1 .
