Long-term follow-up on an intensified treatment regimen for advanced resectable head and neck squamous cell carcinomas

From February 1993 through July 1994, 37 patients with stage III-IV squamou s cell carcinomas of the oral cavity, oropharynx, or hypopharynx (stage II- IV) were registered to a treatment regimen consisting of preoperative conti nuous infusion cisplatin (80 mg/m(2)/80 hours) with hyperfractionated exter nal beam radiotherapy (9.1 Gy/7 fractions of 1.3 Gy BID), surgical resectio n, intraoperative radiotherapy (7.5 Gy), and postoperative,radiotherapy (40 Gy) with concurrent cisplatin (100 mg/m(2) x 2 courses). The objectives of the regimen were to improve patient compliance while also increasing treatment intensity. The purpose of this article is to report t he local, regional (nodal), and distant disease control of these patients a fter an ex tended rime at risk (medial? 40 months). Over-all compliance (73 %), local control at primary site (97%), and regional nodal control (95%) w ere excellent. The rate of distant metastasis was 19%. Absolute survival at 48 months was 45.9%.