Induction chemotherapy followed by hyperfractionated radiotherapy with concurrent chemotherapy for locally advanced head and neck cancer.
BACKGROUND
The aim of this study was to improve tumor control, the survival rate and organ preservation for locally advanced head and neck cancer by using induction chemotherapy followed by hyperfractionated radiotherapy and concurrent chemotherapy.


METHODS
Thirty-five patients with stage III-IVB head and neck cancer were treated with this protocol. Induction chemotherapy consisted of cisplatin and fluorouracil and concurrent chemotherapy consisted of carboplatin and doxifluridin. Radiotherapy was administered twice a day until a dose of 72 Gy was reached.


RESULTS
Twenty-two (63%) and 13 patients (37%) achieved complete responses and partial responses, respectively. In terms of non-hematological toxicities, grade 3 mucositis was observed in 49% of the patients. The overall 5-year survival was 53.5% and the progression-free survival was 40.6%.


CONCLUSIONS
Response to induction chemotherapy was useful as a predictive factor for ultimate outcome and organ conservation. More intensive regimen or other combination chemotherapy is needed to improve treatment outcome with hyperfractionated radiotherapy.
Department of Radiology, School of Medicine, Juntendo University, Tokyo Women's Medical University, Tokyo, Japan. kkarasaw@med.juntendo.ac.jp
Kumiko
K
Karasawa
Hirofumi
H
Shinoda
Kuniaki
K
Katsui
Kaori
K
Seki
Mari
M
Kohno
Nahoko
N
Hanyu
Sachiko
S
Nasu
Hiroyuki
H
Muramatsu
Katsuya
K
Maebayashi
Norio
N
Mitsuhashi
Toshio
T
Yoshihara
D000328:Adult; D000368:Aged; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000009:adverse effects / Q000627:therapeutic use*; D016190:Carboplatin / Q000008:administration & dosage / Q000009:adverse effects; D003131:Combined Modality Therapy; D018572:Disease-Free Survival; D019583:Dose Fractionation, Radiation; D005260:Female; D005467:Floxuridine / Q000008:administration & dosage / Q000009:adverse effects; D005472:Fluorouracil / Q000008:administration & dosage / Q000009:adverse effects; D005500:Follow-Up Studies; D006258:Head and Neck Neoplasms / Q000188:drug therapy* / Q000532:radiotherapy*; D006801:Humans; D008297:Male; D008875:Middle Aged; D010349:Patient Compliance; D012074:Remission Induction
D005467:Floxuridine; D016190:Carboplatin; D005472:Fluorouracil; C025034:doxifluridine