POSTOPERATIVE RADIOTHERAPY WITH CONCURRENT CISPLATIN APPEARS TO IMPROVE LOCOREGIONAL CONTROL OF ADVANCED, RESECTABLE HEAD-AND-NECK-CANCERS - RTOG-88-24

Purpose: Despite aggressive surgery and postoperative radiation therap y, only 30% of patients who have advanced, potentially resectable carc inomas of the head and neck survive for 5 years. In the hope of improv ing this situation we studied the effect of postoperative radiotherapy delivered concurrently with cisplatin, Methods and Materials: Patient s who had Stage IV tumors and/or involved surgical margins received 60 Gy in 30 fractions over 6 weeks plus 100 mg/m(2) of cisplatin on radi otherapy days 1, 23 and 43, Fifty-two patients participated in this tr ial and 51 were evaluated. Forty-three (84%) patients had pathologic T 3 or T4 disease, 43 (84%) had Stage IV disease, and 27 (53%) had histo logically involved surgical margins. Results: Severe and life-threaten ing toxicities occurred in 20% and 12% of patients, respectively; the most common drug-related toxicities were leukopenia, anemia, nausea, a nd vomiting. Seventeen patients (43%) remain alive with no evidence of disease, Four patients (8%) died with no evidence of neoplastic disea se, and one patient has died of a second independent malignancy, By ac tuarial analysis at 3 years, 48% of patients are alive, 81% have locor egional control of disease, and 57% are free of distant metastases. Co nclusions: Based on comparison with similar patients treated in a prio r Radiation Therapy Oncology Group/Intergroup trial (RTOG), we conclud e that postoperative radiotherapy with concurrent cisplatin may improv e locoregional control rates and should be prospectively tested, (C) 1 997 Elsevier Science Inc.