Intensified Regimen for Advanced Head and Neck Squamous Cell Carcinomas

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Abstract
Objective: To devise an intensified treatment regimen for patients with advanced, resectable head and neck squamous cell carcinomas. Design: Phase I/II clinical trial consisting of perioperative cisplatin chemoradiotherapy, surgical resection, intraoperative radiotherapy, and postoperative cisplatin chemoradiotherapy. Setting: The Ohio State University Comprehensive Cancer Center, Columbus. Patients: Thirty-seven patients (median age, 63 years) with advanced oral cavity, oropharyngeal, or hypopharyngeal carcinomas. Results: The range of time at risk was 1 to 30 months (median, 21 months). Thirty of the 37 registered patients were analyzable; 11 have died (5 with distant metastases; 1 of lung carcinoma; and 5 were cancer-free); 2 experienced second primary tumors in the oral cavity (out of or adjacent to the previous radiotherapy portals). Treatment compliance was excellent (92%), morbidity was low, and excellent locoregional control was achieved. Conclusions: The initial results are encouraging; the future strategy will intensify the systemic component of therapy based on results from concurrent laboratory studies. Arch Otolaryngol Head Neck Surg. 1997;123:139-144