Randomised clinical trials describe the benefit of chemotherapy for specific head and neck patients with selected patient and tumour characteristics. This study estimates the overall survival benefit of chemotherapy above all other modalities for the whole population of head and neck cancer patients in Australia, if evidence-guidelines were followed.
Decision trees with evidence-based indications for chemotherapy have been previously defined. For all defined indications, the highest level of clinical evidence available was identified. Multiple electronic citation databases were systematically queried, including Medline and Cochrane library. The benefits of first-course chemotherapy were estimated for 1-year and 5-year overall survivals. To assess the robustness of our estimates, univariate and multivariate analyses were performed.
The estimated 1-year and 5-year absolute population-based survival benefits of optimally utilised chemotherapy for head and neck cancer patients in Australia are 5.5% (95% Confidence Interval, CI, 4.5%-6.8%) and 4.2% (95% CI, 3.6%-5.0%), respectively.
First-course chemotherapy improved population-based survival in head and neck cancer patients, when used in accordence with guidelines recommendations. Measurement of population survival benefits of cancer treatment is important as these can provide salient inputs for economic analyses, aid in priority setting in cancer program and guide quality improvement according to evidence-based guidelines.
Clinical trial identification
Legal entity responsible for the study
CCORE, Ingham Institute for Applied Medical Research, Sydney, Australia.
All authors have declared no conflicts of interest.