RADIATION AND CONCURRENT CARBOPLATIN ADMINISTRATION IN LOCALLY ADVANCED HEAD AND NECK-CANCER - A HELLENIC COOPERATIVE ONCOLOGY GROUP-STUDY

Aims and Background: To improve local control in patients with locally advanced inoperable head and neck cancer we administered carboplatin concurrently with radiation. Methods: Thirty-nine patients entered the study. There were 35 men and 4 women with a median age of 58 years (r ange, 24-74) and a median performance status of 90 (range, 60-100) of the Karnofsky scale. The primary site included nasopharynx (5 patients ), oropharynx (n=10), hypopharynx (n=5), larynx (n=12), oral cavity (n =2), paranasal sinuses (n=3), salivary glands (n=1) and unknown (n=1). Histology was squamous cell carcinoma in all cases. All patients were irradiated with a Co-60 unit. According to the protocol, they should receive 65-70 Gy to the tumor area and 45 Gy to the tumor-free area of the neck, Carboplatin was administered at a dose of 400 mg/m(2) on da ys 2, 22 and 42. Results: Totally, 112 cycles of carboplatin were admi nistered, of which 106 (95%) were at full dose. Median dose intensity of carboplatin actually delivered was 170 mg/m(2)/week (range, 57-200) . All patients were irradiated, although only 30 (77%) received >66 Gy . After the completion of combined treatment, 23 (59%, 95% C.I. 42-74% ) achieved a CR and 10 (26%, 95% C.I. 13-42%) a PR. Grade 3-4 myelotox icity was noticed in 60% of the patients. Other grade 3-4 toxicities i ncluded stomatitis (13%), dysphagia (5%) and weight loss (3%). Median time to progression was 18 months (range, 2-25). Conclusions: Radiatio n and concurrent administration of carboplatin determined a high CR ra te in patients with HNC, although the superiority of this combined mod ality approach over radiation alone has to be proven in phase III tria ls.