title: Long-term results after chemoradiotherapy for locally confined squamous-cell head and neck cancer.
abstract: The long-term results after simultaneous chemoradiotherapy in 54 patients with previously untreated or minimally treated, locally confined (M0) squamous-cell carcinoma of the head and neck are presented. Multiple concurrent courses of radiation therapy and chemotherapy with cisplatin and a four-day 5-fluorouracil infusion were given. Twenty-eight patients underwent definitive surgery and 26 were treated without surgical resection. Treatment-associated toxicity was significant, including mucositis, myelosuppression, and a mean 12% loss of initial body weight. Of the 54 patients, 51 were ultimately rendered disease free by this combined modality protocol. With a follow-up ranging from 42-68 months, the projected Kaplan-Meier relapse-free survival for the entire patient cohort is 70%, with all relapses occurring within 17 months of patient entry. The projected Kaplan-Meier relapse-free survival for patients with Stage IV disease is 62%. The durability of these remissions suggests that there is a significant likelihood of cure in all patients with locally confined disease, and justifies comparative trials with standard treatment.
authors.affiliation: Department of Medicine, Cleveland Metropolitan General Hospital, Ohio.
authors.forename: D J
authors.initials: DJ
authors.lastname: Adelstein
authors.forename: V M
authors.initials: VM
authors.lastname: Sharan
authors.forename: A S
authors.initials: AS
authors.lastname: Earle
authors.forename: A C
authors.initials: AC
authors.lastname: Shah
authors.forename: C
authors.initials: C
authors.lastname: Vlastou
authors.forename: C D
authors.initials: CD
authors.lastname: Haria
authors.forename: S G
authors.initials: SG
authors.lastname: Carter
authors.forename: C
authors.initials: C
authors.lastname: Damm
authors.forename: J D
authors.initials: JD
authors.lastname: Hines
mesh_terms: D000328:Adult; D000368:Aged; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000009:adverse effects / Q000627:therapeutic use*; D002294:Carcinoma, Squamous Cell / Q000188:drug therapy / Q000532:radiotherapy / Q000628:therapy*; D002945:Cisplatin / Q000008:administration & dosage / Q000009:adverse effects; D003131:Combined Modality Therapy; D004334:Drug Administration Schedule; D005260:Female; D005472:Fluorouracil / Q000008:administration & dosage / Q000009:adverse effects; D005500:Follow-Up Studies; D006258:Head and Neck Neoplasms / Q000188:drug therapy / Q000532:radiotherapy / Q000628:therapy*; D006801:Humans; D008297:Male; D008875:Middle Aged; D010865:Pilot Projects; D011379:Prognosis; D011878:Radiotherapy / Q000009:adverse effects; D012074:Remission Induction
chemical_list: D002945:Cisplatin; D005472:Fluorouracil