LOCALLY ADVANCED HEAD AND NECK-CANCER - COMBINED CHEMOTHERAPY AND RADICAL RADIATION-THERAPY FOR ORGAN AND FUNCTION PRESERVATION (INTERIM-REPORT)

PURPOSE: This phase II study was performed to assess the feasibility o f organ preservation after combined chemotherapy and radical radiation therapy in patients with resectable, locally advanced head and neck c ancer. MATERIALS AND METHODS: Twenty-four patients had surgically rese ctable stage III (n = 9) and stage IV (n = 15) squamous cell carcinoma of the head and neck. Initially they received two to three courses of neoadjuvant chemotherapy (5-fluorouracil and cisplatin). Patients in whom response was seen were then treated definitively with two courses of cisplatin chemotherapy administered concomitantly with radical rad iation therapy. Patients in whom no response was seen underwent salvag e surgery or other standard therapy. RESULTS: The response rate after induction chemotherapy was 84% (including 42% complete remission). Com plete remission after concomitant chemotherapy and radical radiation t herapy was 83%. After a median follow-up of 18 months (maximum, 3.5 ye ars) 18 patients (75%) remained recurrence free, Grade 3 or 4 treatmen t-related toxicity was experienced, but there was no treatment-related mortality. CONCLUSION: Combined chemotherapy and radical radiation th erapy used in this study resulted in organ and function preservation i n the majority of patients with resectable stage III and IV head and n eck cancer.