Concurrent chemoradiotherapy for oropharyngeal carcinoma

The clinical results of definitive chemoradiotherapy for oropharyngeal carc inoma were retrospectively analyzed. Thirty-one patients with oropharyngeal carcinoma who received definitive radiation therapy between January 1986 a nd June 1998 were analyzed. The median age was 61 years. All patients had s quamous cell carcinoma. According to the Union International Contre le Canc er 1997 classification system. stage I, II, III, IVA, and IVB were 1, 0, 9. 14. and 7, respectively. Regarding the primary site, 23 tumors were in the lateral wall. whereas 2 were in the superior wall. and 3 each were in the anterior and posterior walls. The median total dose was 66 Gy, with a range of 60 Gy to 74.4, Gy. The overall treatment time ranged from 39 days to 11 3 days, with a median of 50 days. Seven patients underwent hemilateral radi cal neck dissection. Fourteen patients received concurrent chemotherapy usi ng weekly cisplatin (50 mg/d) at least three times. The 5-year overall and cause-specific survival (CSS) rates were 55% and 62%, respectively. All loc al recurrences occurred within 2 years. The CSS rate In patients with later al or superior wall origin was significantly superior to that of patients w ith anterior or posterior wall origin (p < 0.05). The 3-year CSS rate was 8 3% for patients treated with concurrent chemoradiotherapy using weekly cisp latin at least 3 times. whereas that was 53% for the remaining patients (p < 0.05). No serious adverse effects were observed. It is concluded that def initive concurrent chemoradiotherapy using weekly cisplatin for oropharynge al carcinoma appear promising.