Concomitant hyperfractionation of drugs and irradiation in the treatment of advanced ENT cancers

: Considering the limited results achieved up to now in the treatment of advanced ENT-cancer, with the classic customary procedures, the AA. suggest a new therapeutic schedule (within the concurrent radio-chemotherapy context) in which the selected cytotoxic drug, the carboplatin, is a part of each therapeutic fraction. A group of 36 patients suffering advanced ENT-cancer (2 cases stage III and 34 stage IV) were studied between Mars 1993 and September 1995, and the outcomes assessed after a 18 months mean follow-up (30 months maximum). There were 11% surgically rescued cases, being the full dosage administered twice daily 8.050 cGy plus 700 mg carboplatin. Tolerance was very good, so 100% of the patients received a complete treatment. Initial response was also fine resulting 93% full remissions on primaries, 96% on neck adenopathies (6% surgical rescues). Regarding the actuarial control after 30 months were controlled 88% of neck adenopathies, control loco-regional amounted for 69%, control on primaries 63% and actuarial survival amounted 55%. The AA. drawn out 10 conclusions, underlining the good tolerance of the therapeutic sketch proposed, because the antineoplastic results are by far better than those experienced with whichever modality of management of tumors of these sites and staging.