Accelerating hyperfractionation for carcinoma of the head and neck

A lthough control and cure rates for early cancer of the head and neck are good, advanced, unresectable lesions in these sites remain a therapeutic problem, l Induction or adjuvant chemotherapy, alone or in conjunction with conventional irradiation, has not resulted in great improvement] While hyperfractionated radiation therapy regimens have offered some gain in response and local control, toxicity is frequently great. 3'4 At the University of Miami, we have pursued treatment strategies for these tumors that seek to combine effective chemotherapeutic regimens with innovative and more rational approaches to irradiation. In particular, we have sought to exploit the dynamic nature of the various factors governing growth of tumors and normal tissues.