Unresectable primary and recurrent head and neck tumors: Effect of hyperthermia and carboplatin-preliminary experience

PURPOSE: To perform a single-arm study to determine the effectiveness of an d potential toxic reactions to local hyperthermia and systemic carboplatin (cis-diammine-1,1-cyclobutane dicarboxylate platinum II) for the treatment of advanced or recurrent squamous cell carcinomas of the head and neck. MATERIALS AND METHODS: Eight patients with squamous cell carcinoma of the h ead and neck and stage IV disease (N2 or N3 neck adenopathy) or recurrent l ocal-regional disease and who were previously and definitively treated were included in I:the study. Thermochemotherapy was administered every 4 weeks . Recorded end points were tumor response, duration of response, incidence of distant metastases, survival, cause of death, and toxic reactions. RESULTS: One patient had a complete response to therapy, and two had a part ial response. Five patients had no response or developed progressive diseas e during therapy. Six patients died after 4-13 months of progressive diseas e. Two long-term survivors received radiation therapy; one also underwent s urgical resection for residual neck disease. Each thermochemotherapeutic se ssion was well tolerated, with minimal discomfort. Toxic reactions included hypotension, vomiting, hyponatremia, anemia, thrombocytopenia, and infecti on at the site of administration. there were no life-threatening toxic reac tions. CONCLUSION: The combined use of hyperthermia and carboplatin shows potentia l in the management of unresectable head and neck tumors and is safe and we ll tolerated. Further studies on thermochemotherapy are warranted to assess its potential.