ACCELERATED BIFRACTIONATED RADIATION WITH CONCURRENT CISPLATIN ADMINISTRATION IN LOCALLY ADVANCED HEAD AND NECK-CANCER - A FEASIBILITY STUDY

Aims and Background: To test the feasibility of accelerated interrupte d twice-daily radiation and concurrent cisplatin administration in pat ients with locally advanced head and neck cancer. Patients and Methods : Nineteen patients with locally advanced head and neck cancer were tr eated with accelerated bifractionated radiation with concurrent admini stration of cisplatin. There were 18 men and 1. female with a median a ge of 60 years (range, 17-71) and median performance status of 90 (ran ge, 80-100). Sixteen patients (85%) presented with stage IV disease. P rimary site included the nasopharynx (n = 7), oropharynx (n = 5), hypo pharynx (n = 1) and larynx (n = 6). Radiation consisted of two fractio ns of 1.6 Gy each daily, five times weekly to a total dose of 64 Gy. C isplatin was administered at a dose of 100 mg/m(2) on days 2 and 28 of the treatment period. Results: Nine patients achieved a complete resp onse (47%; 95% CI, 25%-70%) and 5 a partial response (26%; 95% CI, 7%- 46%). Grade III-IV toxicity included leukopenia (16%), mucositis (26%) , dry mouth (5%), weight loss (16%) and infection (5%). After a median follow-up of 27.11 months (range, 1-33+), 9 patients have died. Media n time to progression was 11 months (range, 1-32+) and median survival 25 months (range, 1-32+). Conclusions: Accelerated twice-daily radiat ion with concurrent cisplatin is effective in locally advanced head an d neck cancer and can be safely given with manageable toxicity.