{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,1]],"date-time":"2026-10-01T22:02:06Z","timestamp":1790892126585,"version":"4.1.0"},"reference-count":27,"publisher":"SAGE Publications","license":[{"start":{"date-parts":[[2026,9,30]],"date-time":"2026-09-30T00:00:00Z","timestamp":1790726400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["The American Surgeon\u2122"],"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Multimodality treatments involving radical surgery followed by high-dose cisplatin-sensitized chemoradiotherapy (SCCRT) now are standard of care for Stages III and IV SCCHN, with 5-year survival remaining 25-50%. Simultaneous fractionated cisplatin and radiation therapy (CTRT) is promising. Objective: to review SCCHN treatment history while evaluating parallel CTRT development.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      The history of surgical, radiotherapy (RT), chemotherapy, immunotherapy, and multimodal SCCHN was reviewed. 187 Stages III\/IV SCCHN CTRT patients (cisplatin 20\u00a0mg\/M\n                      <jats:sup>2<\/jats:sup>\n                      IV 4 consecutive days weeks 1, 4, of 7000-7400 cGy (RT)) were examined. CTRT results: CCR = Clinical Complete Response\u2013no clinical tumor. PCR = Partial Clinical Response\u2013clinical residual tumor. HCR = Histologic Complete Response\u2013tumor-free biopsy of primary site. Statistics: Chi-squared, ANOVA, and Kaplan-Meier.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Fifty years of evolution in SCCHN Stage III\/IV treatment identified curative surgery plus combined high-dose cisplatin\/radiotherapy as standard of care, with 5-year survival &lt;50% and significant toxicity, leading up to 40% not completing the third round of CCRT. CTRT data: All primary tumor sites included. Stage IV (74%) and Stage III (26%). T4\/T3 = 89.9%. CTRT Toxicity: Grade 0 = 32.26%, 1 = 13.98%, 2 = 38.71%, 3 = 14.52%, 4 = 0.54%, and 5 = 0%. CCR overall 152\/187 (81.28%). 182\/187 (98%) biopsied, 145\/182 HCR (79.67%). CTRT response did not vary by primary site, Stage, sex, and T category. 11 (6%) had surgery for residual disease post-CTRT. 51\/187 (27.3%) recurred. Kaplan-Meier 5-year (71.58%) and 10-year (60.72%) overall survival; 5-year (63.01%) and 10-year (49.38%) disease-free survival.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Discussion<\/jats:title>\n                    <jats:p>Advances have improved SCCHN local control, but survival remains sub-optimal. CTRT might be an alternative to surgery plus high-dose cisplatin chemoradiotherapy, potentially increasing organ preservation and survival with reduced operative morbidity and toxicity.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/00031348261493536","type":"journal-article","created":{"date-parts":[[2026,9,30]],"date-time":"2026-09-30T15:08:34Z","timestamp":1790780914000},"update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":0,"title":["The Circular Evolution of Treatment for Advanced Operable Stage III and IV Squamous Cell Carcinoma of the Head and Neck (SCCHN): Standard of Care History and New Data on Fractionated Cisplatin Chemoradiotherapy"],"prefix":"10.1177","author":[{"ORCID":"https:\/\/orcid.org\/0009-0000-4229-771X","authenticated-orcid":false,"given":"Jason X.","family":"Tran","sequence":"first","affiliation":[{"name":"Inspira Health Network"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nicole","family":"Stouffer","sequence":"additional","affiliation":[{"name":"Inspira Health Network"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Venkateswar","family":"Venkataraman","sequence":"additional","affiliation":[{"name":"Department of Medical Education & Scholarship, Rowan-Virtua SOM"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gus J.","family":"Slotman","sequence":"additional","affiliation":[{"name":"Inspira Health Network"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2026,9,30]]},"reference":[{"key":"e_1_3_3_2_2","doi-asserted-by":"publisher","DOI":"10.1038\/nrc1529"},{"key":"e_1_3_3_3_2","doi-asserted-by":"publisher","DOI":"10.1093\/annonc\/3.suppl_3.s11"},{"key":"e_1_3_3_4_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa070956"},{"key":"e_1_3_3_5_2","doi-asserted-by":"publisher","DOI":"10.1177\/107327480200900504"},{"key":"e_1_3_3_6_2","doi-asserted-by":"publisher","DOI":"10.1002\/1097-0142(19860315)57:6<1110::aid-cncr2820570608>3.0.co;2-6"},{"key":"e_1_3_3_7_2","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2025.21733"},{"key":"e_1_3_3_8_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMra1715715"},{"key":"e_1_3_3_9_2","doi-asserted-by":"publisher","DOI":"10.1002\/hed.26885"},{"key":"e_1_3_3_10_2","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.2012.43.6097"},{"key":"e_1_3_3_11_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.radonc.2021.01.013"},{"key":"e_1_3_3_12_2","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2022.13997"},{"key":"e_1_3_3_13_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijrobp.2025.05.086"},{"key":"e_1_3_3_14_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(25)01850-1"},{"key":"e_1_3_3_15_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa2415434"},{"key":"e_1_3_3_16_2","doi-asserted-by":"publisher","DOI":"10.1001\/jamaoto.2024.5254"},{"key":"e_1_3_3_17_2","doi-asserted-by":"publisher","DOI":"10.3390\/cancers18111679"},{"key":"e_1_3_3_18_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(18)32752-1"},{"key":"e_1_3_3_19_2","doi-asserted-by":"publisher","DOI":"10.3389\/fimmu.2025.1576042"},{"key":"e_1_3_3_20_2","doi-asserted-by":"publisher","DOI":"10.1001\/archotol.1985.00800040078011"},{"key":"e_1_3_3_21_2","doi-asserted-by":"publisher","DOI":"10.1002\/hed.2890080306"},{"key":"e_1_3_3_22_2","doi-asserted-by":"publisher","DOI":"10.1002\/1097-0142(19920601)69:11<2736::aid-cncr2820691118>3.0.co;2-s"},{"key":"e_1_3_3_23_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.amjsurg.2014.10.018"},{"key":"e_1_3_3_24_2","volume-title":"SAS\/STAT\u00ae 9.22 User\u2019s Guide","author":"SAS Institute Inc","year":"2010","unstructured":"SAS Institute Inc. 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