Concomitant chemoradiotherapy followed by adjuvant chemotherapy in parotidgland undifferentiated carcinoma

Aims and background: Undifferentiated carcinoma of the parotid gland is a p oor-prognosis lesion. Results in unresectable lesions, treated with radioth erapy alone, are very disappointing. Methods: Six patients with T3-4 N0-1 inoperable lesions were treated with c onventional radiotherapy (64-70 Gy, 2 Gy per fraction 5 times a week) and c oncomitant cisplatin (100 mg/m(2), days 1, 22 and 43). Four weeks after rad iotherapy, adjuvant chemotherapy (cisplatin, 80 mg/m(2), day 1, + VP16, 100 mg/m(2), days 1, 3 and 5, q = 3 weeks, for 3 cycles) was given. Results: A median dose of 66 Gy (range, 64-70 Gy) was delivered, and all pa tients received 3 courses of cisplatin during radiotherapy. Five of 6 patie nts received all three chemotherapeutic adjuvant courses. Two months after the end of treatment, 3 CR (50%), 2 PR (33%) and 1 NC (16%) was observed. M edian CR and PR duration was 26+ and 10 months, respectively. Median overal l survival was 18 months. No severe acute or late toxicity was observed. Conclusions: Concomitant chemoradiotherapy followed by adjuvant chemotherap y in advanced unresectsble undifferentiated parotid carcinoma is feasibile and well tolerated. The high percentage of long-lasting CR is encouraging.