{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,6]],"date-time":"2026-10-06T15:37:19Z","timestamp":1791301039475,"version":"4.1.0"},"reference-count":23,"publisher":"American Medical Association (AMA)","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JAMA Otolaryngol Head Neck Surg"],"abstract":"Importance<\/jats:title>Despite the widespread use of carboplatin\/paclitaxel (C\/P) in concurrence with radiotherapy for patients with squamous cell carcinoma of the head and neck (SCCHN) who are ineligible to receive cisplatin, there is a lack of prospective or comparative analyses examining C\/P vs cisplatin.<\/jats:p><\/jats:sec>Objective<\/jats:title>To examine the clinical outcomes of patients with SCCHN receiving C\/P vs cisplatin in concurrence with radiotherapy in the definitive and postoperative setting.<\/jats:p><\/jats:sec>Design, Setting, and Participants<\/jats:title>This retrospective, single-center comparative effectiveness study included patients with SCCHN who received concurrent chemoradiotherapy with C\/P or cisplatin from January 2010 to March 2021. Patients with human papillomavirus\u2013related and unrelated disease were included. Data analysis was conducted in March 2022.<\/jats:p><\/jats:sec>Exposures<\/jats:title>Patients received C\/P or cisplatin. Most cisplatin patients received weekly cisplatin or C\/P. Intensity-modulated radiotherapy was primarily used, with a median (range) total dose of 70 (66-70) Gy.<\/jats:p><\/jats:sec>Main Outcomes and Measures<\/jats:title>Key efficacy end points were locoregional recurrence\u2013free survival (LRFS), progression-free survival (PFS), distant metastasis\u2013free survival (DMFS), overall survival (OS), and safety.<\/jats:p><\/jats:sec>Results<\/jats:title>A total of 308 patients were included (66 female individuals [21.4%]; 60 African American individuals [19.5%], 9 Asian individuals [2.9%], 3 Hispanic individuals [1.0%], and 235 White individuals [76.3%]; median [range] age, 63 [24-89] years). Of these patients, 116 (37.7%) had never smoked, 117 (38.0%) formerly smoked, and 75 (24.4%) were active smokers. Primary sites were oropharynx (164 [53.2%]; 164 [84.7%] were human papillomavirus\u2013positive), oral cavity (57 [18.5%]), and larynx (52 [16.9%]); a comparison of illness stage was T3\/T4 (191 [62.0%]) vs T1\/T2 (117 [38.0%]) and N1 to N3 (258 [83.8%]) vs N0 (50 [16.2%]). A total of 97 patients (31.5%) underwent surgery before concurrent therapy. No meaningful differences between cisplatin and C\/P were observed for 3-year rates of LRFS (97.0% vs 96.2%; difference, \u22120.8%; 95% CI, \u22125.2% to 3.6%), PFS (77.5% vs 79.8%; difference, 2.3%; 95% CI, \u22127.4% to 12.0%), DMFS (83.4% vs 86.8%; difference, 3.4%; 95% CI, \u22125.3% to 12.1%), or OS (90.8% vs 92.9%; difference, 2.1%; 95% CI, \u22124.5% to 8.7%). C\/P was associated with a higher rate of grade 3 to 4 leukopenia, anemia, and dermatitis and more feeding tube placements and hospitalizations.<\/jats:p><\/jats:sec>Conclusions and Relevance<\/jats:title>The results of this study suggest that there were no differences in LRFS, PFS, DMFS, and OS in patients with SCCHN receiving radiotherapy with C\/P vs cisplatin. These results support the use of C\/P as an alternative regimen in patients who cannot receive cisplatin.<\/jats:p><\/jats:sec>","DOI":"10.1001\/jamaoto.2025.1706","type":"journal-article","created":{"date-parts":[[2025,6,26]],"date-time":"2025-06-26T15:31:10Z","timestamp":1750951870000},"source":"Crossref","is-referenced-by-count":3,"title":["Radiotherapy With Cisplatin vs Carboplatin Paclitaxel for Head and Neck Squamous Cell Carcinoma"],"prefix":"10.1001","author":[{"given":"Marin","family":"Abousaud","sequence":"first","affiliation":[{"name":"Astellas Pharma Global Development Inc, Astellas Pharma, Northbrook, Illinois"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Saagar","family":"Pamulapati","sequence":"additional","affiliation":[{"name":"Advocate Hematology and Oncology Fellowship, Lutheran General, Park Ridge, 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