Concurrent chemotherapy and "concomitant boost" radiotherapy for unresectable head and neck cancer

Purpose: For patients with advanced head and neck cancer, various combined chemoradiotherapy regimens have been used to improve local control. This st udy was carried out to assess the outcome of concomitant chemotherapy with a "concomitant boost" radiotherapy in the treatment of advanced unresectabl e head and neck cancer patients. Materials and Methods: Forty-eight patients were treated with combined chem oradiotherapy between the years of 1990 and 1995. Cisplatinum (100 mg/m2) w as given intravenously during week 1 and week 5. A "concomitant boost" exte rnal beam radiotherapy approach was used with twice-daily treatment deliver ed during the last 2 weeks. A total of 70 Gy was delivered over 6 weeks. Me dian follow-up was 23.5 months (2-79 months). Results: Thirty-one (65%) and 17 (35%) patients achieved complete and parti al response, respectively. Median survival in complete responders has not b een reached. Overall survival at 2 years, 3 years, and 5 years were 58.7%, 52.8%, and 42.4%, respectively. Median overall survival was 38.8 months. Ac ute confluent mucositis (Radiation Therapy Oncology [RTOG] grade 3) develop ed in 50% of patients, but there was no severe long-term treatment-related toxicity. Conclusion: This combined chemoradiotherapy approach is safe and efficaciou s for advanced unresectable head and neck cancer. Treatment-related toxicit y was acceptable with 50% of patients developing acute confluent mucositis. There was no severe long-term treatment-related toxicity.