FEASIBILITY OF NON-CISPLATIN-BASED INDUCTION CHEMOTHERAPY AND CONCURRENT CHEMORADIOTHERAPY IN ADVANCED HEAD AND NECK-CANCER

The purpose of the present study was to determine the safety and effic acy of induction chemotherapy followed by concomitant chemoradiotherap y. Thirty-eight patients were randomised to receive induction chemothe rapy, consisting of cyclophosphamide and methotrexate followed by conc omitant 5-fluorouracil and irradiation (study group) or irradiation al one (control group). There were non-significant differences in the ini tial tumor clearance rates in the two groups. Median disease-free surv ival (in complete responders) was 17 months (6-60+) vs 11 months (5-60 +) (p = 0.407) and overall survival 11 months (1-60+) vs 14 months (2- 60+) (p = 0.428) in the study and control groups respectively. Acute m orbidity and deaths during intervention were higher in the study group (p = 0.007). This study suggests that induction along with concomitan t chemoradiotherapy is too toxic for routine use and also fails to pro vide a survival benefit.