Radiation therapy, cisplatin and hyperthermia in combination in managementof patients with recurrent carcinomas of the head and neck with metastaticcervical lymph nodes

Twenty-one patients with recurrent carcinomas of the head and neck with met astatic cervical lymph nodes were treated with radiation therapy, cisplatin and hyperthermia in combination, in an attempt to investigate any potentia l contribution in terms of safety, response, duration of palliation and qua lity of life. Patients not initially treated with radiation therapy were tr eated with a median dose of 70 Gy and patients initially treated with radia tion therapy with a median dose of 30 Gy. The median number of weekly cispl atin courses was five and the median number of twice weekly local external ultrasound hyperthermia sessions was five. Average Tg,, Average T-50 and Av erage T-10 were 39.9 +/- 1.2 degrees C, 42.4 +/- 1.3 degrees C and 44.5 +/- 0.8 degrees C, respectively, and Average CEM 43 degrees C T-90, Average CE M 43 degrees C T-50 and Average CEM 43 degrees C Tio were 7.8 +/- 9.6 min, 22.6 +/- 18.8 min and 39.3 +/- 25.1 min, respectively. Mean follow-up was 1 year. Nodal complete response was achieved in eight patients and palliatio n of presenting symptoms in 19. Overall survival was 39% at 1 year. Grade 3 acute skin toxicity was observed in one patient and Grade 3 acute haematol ogical toxicity in one. Radiation therapy, cisplatin and hyperthermia in co mbination appear to be safe and might improve response, prolong duration: o f palliation and reinstate quality of life in patients with recurrent carci nomas of the head and neck with metastatic cervical lymph nodes.