Abstract
Thirty-six patients, previously untreated,(7 with stage III and 29 with stage IV; 25 with respectable and 11 with unresectable) were treated with concurrent chemoradiotherapy. The primary site was identified in the hypopharynx in 9, sinuses in 8, larynx in 6, nasopharynx in 4, oropharynx in 4, oral cavity in 3, parotis in 1, unknown primary in 1 patients. Treatment consisted of 5-fluorouracil (5-FU), 1000mg/m2 per day, given as continuous infusions during 4 days, and cis-platinum (CDDP), 60mg/m2 were given on day 4 beginning on day 1 and 35 of a concurrent radiotherapy course. Radiation was given in single daily fraction of 2Gy, to a total dose of 60 to 70Gy. Radiation breaks were scheduled from day 26 to 35. Toxicities included mucositis (grade 3, 33%, grade 4, 11%), vomiting (grade 3, 44%), leukopenia (grade 3, 17%), anemia (grade 3, 3%). According to gastrointestinal toxicity, scheduled drug was given 81% for the second course. The mean total delivered dose of radiation was 65.4Gy. The mean duration of the radiotherapy interruption was 5.1 days. There was no death secondary to treatment. Twelve (33%) and 22 patients (61%) had clinical complete and partial response. This chemoradiotherapy regimen, although toxic, is tolerable with appropriate supportive intervention and loco-regional control is good.
