CONTINUOUS COURSE RADIATION-THERAPY AND CONCURRENT COMBINATION CHEMOTHERAPY FOR SQUAMOUS-CELL HEAD AND NECK-CANCER

Concurrent radiation therapy and chemotherapy is a promising approach to the treatment of squamous cell head and neck cancer. Toxicity, howe ver, has required either scheduled breaks in radiation therapy adminis tration or compromise in chemotherapy dose intensity. We describe the toxicity and results in 19 patients treated at diagnosis with a contin uous course of radiation therapy and intensive concurrent combination chemotherapy using 5-fluorouracil and cisplatin. Toxicity among these 19 patients was significant, including mucositis, myelosuppression, an d weight loss, and aggressive supportive efforts were required. No tox ic deaths occurred, however. At the end of treatment, all patients had achieved complete control of their primary-site tumor. Primary-site r esection was not required in any patient for tumor control, but neck d issections were performed in selected individuals with involved nodes at diagnosis. No patient recurred at the primary site and only a singl e patient recurred in the neck. We conclude that this chemoradiotherap y schedule is very effective, albeit toxic. Toxicity, however, can be managed with appropriate aggressive supportive measures. Conformation of these encouraging treatment results will require performance of a r andomized clinical trial.