CONCOMITTANT RADIOCHEMOTHERAPY WITH CISPLATINUM AND5-FLUOROURACIL IN LOCALLY ADVANCED HEAD AND NECK CANCER

Between March 1995-October 1997, 33 cases with locally advanced head and neck carcinomas received 70 Gy external RT (2 Gy/fraction) concurrently with 3 courses of cisplatin (70 mg/m2, D1, 22,43) and 5-Fluorouracil (500 mg/m2/d by 8 hour infusion) on first 3 days of each courses. The median age was 51. Four cases (12.1 %) were stage III, whereas 29 cases (87.9%) were stage IV, The tumor localization were as follows; 9 (27.3) larynx, 12 (36.3%) hypopharynx, 6 (18.2%) oropharynx, 4 (12.1%) oral cavity, 2 (6.1%) maxillary sinus. Median follow up time was 14 months (8-38 months) and 32 cases (97%) were able to receive at least 2 courses of chemotherapy. There was not any life threatening grade IV acute or late complications. Twenty-two (66.7%) complete, 8 (24.2%) partial, 2 (6.1%) stable responses were obtained, whereas in 1 case (3.0%) there was progression two months after the end of the treatment. During follow up 7 (21.2%) local, 1 (3%) local-regional progression and 2 (6.1%) distant metastasis were observed. Overall survivals at 1 and 2 years were 69.7% and 59.7% respectively. Less than one week (19 cases) or more protraction of radiotherapy (14 cases) was not found to influence overall survival time and ratios (P=0.354). In this study conventional radiotherapy without planned split was given concomitantly with chemotherapy and the results were evaluated as similar to the results achieved with the other concomitant chemoradiotherapy trials. It was concluded that it might be appropriate to compare this regimen with standard regimens.