title: [Simultaneous radiochemotherapy with carboplatin in patients with inoperable advanced stage III and IV head and neck tumors].
abstract: BACKGROUND
  The results of treating advanced tumors in the head and neck region with radiotherapy alone are disappointing. Concurrent radiotherapy and chemotherapy may improve this situation. The treatment results of concurrent radiochemotherapy at the University of Rostock were analyzed retrospectively.
  
  
  METHODS
  From 1991 to 1996 92 patients with head and neck tumors were treated with concurrent radiochemotherapy (1.8 to 63 Gy; 70 mg/m2 carboplatin day 1 to 5 and 29 to 33) with palliative tumor resection (n = 37) or without surgical treatment (n = 55). Remission rate, overall survival and disease-free survival, local control and acute toxicity were analyzed.
  
  
  RESULTS
  Six weeks after radiochemotherapy 56.5% of patients had a complete remission, 36% a partial remission and 7.5% "no change". With a median follow-up of 42 months (6 to 74 months) overall survival, disease-free survival and local control were 24.3%, 28.9%, 18.0% 5 years after treatment. All these criteria were significantly better in patients with palliative tumor resection compared to no surgical treatment (uni- and multivariate) and in patients with Stage III than in patients with Stage IV carcinomas (univariate), overall survival was significantly better in patients with Stage III (multivariate). A pretherapeutic Hb level below 7.0 mmol/l (11.27 g/dl) reduced the local control significantly (uni- and multivariate). Grade III and IV mucositis was detected in 10%, Grade III leucopenia in 12% of treated patients. Grade IV leucopenia and Grade III thrombopenia were observed in 1 patient each.
  
  
  CONCLUSIONS
  The toxicity of this treatment is tolerable. However, additional trials must be conducted before considering the palliative tumor resection as standard therapy.
authors.affiliation: Klinik und Poliklinik für Strahlentherapie, Medizinische Fakultät, Universität Rostock.
authors.forename: R
authors.initials: R
authors.lastname: Mücke
authors.forename: M
authors.initials: M
authors.lastname: Blynow
authors.forename: P G
authors.initials: PG
authors.lastname: Ziegler
authors.forename: T
authors.initials: T
authors.lastname: Libera
authors.forename: G
authors.initials: G
authors.lastname: Kundt
authors.forename: S
authors.initials: S
authors.lastname: Dommerich
authors.forename: B
authors.initials: B
authors.lastname: Kramp
authors.forename: R
authors.initials: R
authors.lastname: Fietkau
mesh_terms: D000328:Adult; D000368:Aged; D000970:Antineoplastic Agents / Q000627:therapeutic use*; D016190:Carboplatin / Q000627:therapeutic use*; D002294:Carcinoma, Squamous Cell / Q000188:drug therapy* / Q000401:mortality / Q000473:pathology / Q000532:radiotherapy*; D003131:Combined Modality Therapy; D003627:Data Interpretation, Statistical; D018572:Disease-Free Survival; D005260:Female; D005500:Follow-Up Studies; D006258:Head and Neck Neoplasms / Q000188:drug therapy* / Q000401:mortality / Q000473:pathology / Q000532:radiotherapy*; D006801:Humans; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D009367:Neoplasm Staging; D010166:Palliative Care; D011879:Radiotherapy Dosage; D012189:Retrospective Studies; D015996:Survival Rate; D013997:Time Factors
chemical_list: D000970:Antineoplastic Agents; D016190:Carboplatin