Concurrent or concomitant systemic therapy or chemotherapy is a concept wherein chemotherapy is administered along with another treatment simultaneously like radiation. It is now called radiochemotherapy. This treatment is tried in clinical trials for many forms of cancer at various research institutes and cancer centers. A comparative analysis has been done in one of the clinical trials in case of oropharyngeal cancer wherein patients who were given only radiation therapy were compared with patients who were given concurrent chemotherapy along with radiation. They found out that the survival rate and the quality of life was much better in the patients treated with concurrent chemotherapy than the ones treated only with radiation. Of course, this treatment is extremely intensive and can cause many side effects. However, if the benefits outweigh the side effects then the treatment is worth trying.

A group of a few hundred patients with stage III or IV locally advanced squamous cell carcinoma of the oropharynx were randomly given standard daily fraction of chemotherapy radiation therapy  where carboplatin and 5-fluorouracil (5-FU) were given as chemotherapy drugs for 4 days. After 35 months, the statistical data showed a 3-year disease free survival with an improved quality of life.

Simultaneously, some patients with the same disease were administered chemotherapy with carboplatin and 5-FU alone and the other set of patients were administered only radiotherapy. The comparative analyses showed a decent survival rate for cancer radiation and chemotherapy treatment.

However, the platinum compound carboplatin and 5-FU drugs seemed to increase the mucocutaneous toxic effects, cause weight loss and difficulty in swallowing. Hence, these patients required feeding tubes. The interruptions in the treatment were more for the radiochemotherapy patients; however, the overall time required for both the treatments was almost the same. Chemotherapy was stopped after radiotherapy was completed; hence, some patients did not receive the third cycle. Majority of the patients completed radiotherapy.

Broadly speaking, according to the data available in this case, there are many positive trials of radiochemotherapy being done now. These trials contain patients with respectable as well as non-resectable tumors i.e. the ones, which cannot be removed surgically. Most of these cases were of oropharyngeal cancers and a few with cancers in other organs. Hence, it is now evident that radiochemotherapy substantially improves the survival rate as compared to radiotherapy alone. Radiochemotherapy could now be considered as a standard treatment in case of oropharyngeal cancer.

This however raises a number of issues like when should radiochemotherapy be used as the first line of treatment. Obviously, it would mainly be for people with locally advanced tumors especially the ones, which cannot be removed surgically.

Concurrent chemotherapy has also been tried in clinical trials of treatment for non-small cell lung cancer. Concomitant radio-chemotherapy using platinum compounds seemed to improve the survival rate of patients with locally advanced non-small cell lung carcinoma. It is not yet clear whether the addition of chemotherapy improves survival, as there was no consistency in the results.

Concurrent chemotherapy or radiochemotherapy is yet to become the standard treatment although it seems to have many potential benefits apart from the side effects. Clinical trials are being done rigorously to derive statistical data and comparative analyses of this treatment against the conventional treatments.