Simultaneous radiochemotherapy versus concomitant boost radiation for advanced inoperable head and neck cancer

In this prospective, non-randomized study we compare the results of simulta neous radiochemotherapy (RCT) with those of concomitant boost treatment (CB T) in advanced head and neck cancer. From January 1993 to March 1999, 77 pa tients were treated with cisplatin, 5-FU, and 70.2 Gy (accelerated split-co urse): from January 1995 to March 1999, a further 33 patients received CBT to a total dose of 72 Gy. Toxicities were prospectively recorded according to RTOG/EORTC criteria. Acute and subacute reactions did not differ signifi cantly. Severe late effects (III/IV) remained anecdotal tone fistula). Ther apy-associated mortalities were 3% (RCT) vs. 0% (CBT), most: tumors respond ing well to therapy (CR + PR: RCT: 72%, CBT: 63%). The 2-year probabilities for freedom from locoregional progression amounted to 42% (RCT) and 31% (C BT); p > 0.05. Tumor-specific 2-year survival amounted to 40% (RCT) and 34% (CBT); p > 0.05. Both of the treatment concepts yield high remission rates with moderate toxicities. Nevertheless, median time to recurrence is still fairly short. We could not find any differences for local control and surv ival. For patients who are not able to complete the full three courses of r adiochemotherapy, the concomitant boost schedule presents a good alternativ e.