LOCAL HYPERTHERMIA, HYPERFRACTIONATED RADIATION, AND CISPLATIN IN PREIRRADIATED RECURRENT LYMPH-NODE METASTASES OF RECURRENT HEAD AND NECK-CANCER

Large tumor size is a negative prognostic variable for attaining compl ete regression (CR) with local hyperthermia (HT) and radiotherapy (RT) . Such poor prognosis lesions (i.e., >7 cm(2) or >14 cm(3)) have an ex pected CR rate of similar to 30+/-8%. To improve on this result we add ed cisplatin to HT and RT with standard fractionation (std Fx) in an e arlier study, and observed a 19% CR rate in head and neck (H&N) patien ts. We now report the results of a second generation trial combining H T, cisplatin (40 mg/m(2)) and hyperfractionated RT in a series of 13 p retreated poor prognosis H&N patients. Therapy encompassed 44 triple m odality sessions and was well tolerated: toxicity included one episode of grade-3 skin reaction and one grade 1 leukopenia. Although the ove rall remission rate was 92%, the CR rate was only 8%; this resulted in early closure of this trial concluding that hyperfractionated RT had no (over std Fx RT) benefit in this combined modality approach.