SIMULTANEOUS RADIOCHEMOTHERAPY IN THE TREATMENT OF INOPERABLE, LOCALLY ADVANCED HEAD AND NECK CANCERS - A SINGLE-INSTITUTION STUDY

Background. Patients with advanced, inoperable head and neck cancers h ave cure rates of approximately 10-15%. In these patients, concomitant chemoradiotherapy seems to improve local control and survival. 9-Fluo rouracil (5-FU) administered by continuous infusion and cisplatin plus concomitant conventional radiation therapy may be promising in treati ng advanced, inoperable head and neck cancers. Methods. Forty-five eva luable patients with primary nonmetastatic, inoperable head and neck c ancers were treated. From January 1987 to April 1988, the patients wer e treated with cisplatin plus radiation therapy (Group 1) and from May 1988 to November 1990, they were treated with the same combination pl us 5-FU, given in continuous infusion (Group 2). Clinical and patholog ic responses were assessed after radiation therapy was completed, Pati ents who relapsed underwent salvage surgery, if possible. The disease free and overall survival rates of the patients were evaluated. Result s. The overall response rate (complete and partial response) was 93%, 60% of which comprised complete remissions. Despite the high response rates obtained in the two groups, the time to progression for complete responses and the median survival time were unsatisfactory (13 [Group 1] and 10 months [Group 2] and 17 [Group 1] and 16 months [Group 2], respectively). The toxicity rate from the two treatments was not relev ant. A Grade II mucositis, according to the World Health Organization, was found in 25 patients, and the treatment was interrupted for 7-10 days in 5. Conclusions. In this study, despite an improvement in the n umber of complete responses, the chemotherapeutic regimen with or with out 5-FU did not prolong the overall patient survival significantly.